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Sample records for australian rural communities

  1. Implementation of oral health initiatives by Australian rural communities: Factors for success.

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    Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

    2018-01-01

    In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.

  2. Organizational Responsibility for Age-Friendly Social Participation: Views of Australian Rural Community Stakeholders.

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    Winterton, Rachel

    2016-01-01

    This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.

  3. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

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    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  4. Rural and remote speech-language pathology service inequities: An Australian human rights dilemma.

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    Jones, Debra M; McAllister, Lindy; Lyle, David M

    2018-02-01

    Access to healthcare is a fundamental human right for all Australians. Article 19 of the Universal Declaration of Human Rights acknowledges the right to freedom of opinion and to seek, receive and impart information and ideas. Capacities for self-expression and effective communication underpin the realisation of these fundamental human rights. For rural and remote Australian children this realisation is compromised by complex disadvantages and inequities that contribute to communication delays, inequity of access to essential speech-language pathology services and poorer later life outcomes. Localised solutions to the provision of civically engaged, accessible, acceptable and sustainable speech-language pathology services within rural and remote Australian contexts are required if we are to make substantive human rights gains. However, civically engaged and sustained healthcare can significantly challenge traditional professionalised perspectives on how best to design and implement speech-language pathology services that seek to address rural and remote communication needs and access inequities. A failure to engage these communities in the identification of childhood communication delays and solutions to address these delays, ultimately denies children, families and communities of their human rights for healthcare access, self-expression, self-dignity and meaningful inclusion within Australian society.

  5. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

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    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

    2013-09-01

    Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

  6. Embracing autism in Canadian rural communities.

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    Hoogsteen, Lindsey; Woodgate, Roberta L

    2013-06-01

    The purpose of this study was to explore the lived experience of Canadian parents living in rural areas who were parenting a child with autism. A phenomenological design described by van Manen was applied to guide this study. This study took place in rural communities of Western Canada. Purposive sampling was used to recruit 26 families parenting a child with autism in rural communities. Participants ranged in age from 26 to 50 years old and lived an average of 197 kilometres away from an urban city. Parents of children with autism took part in audio-taped, in-depth interviews. A total of 26 open-ended interviews were completed over four months with an average of 83 minutes per interview. All interviews and field notes were transcribed verbatim and analyzed using van Manen's selective highlighting approach. When describing the characteristics of living rurally while parenting a child with autism, parents reported that the rural community had (i) less of everything, (ii) safety and familiarity, and (iii) a family of support. Parents believed that although there were disadvantages to living in a rural community, parents felt isolated in terms of services but not in terms of the support received by the community. The results of this study add to our knowledge of parenting experiences with attention to the rural experience and furthermore, recommendations for nurses and health care professionals were provided. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  7. Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.

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    Carlisle, Karen; Larkins, Sarah; Croker, Felicity

    2017-01-01

    The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland. Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort. Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population. The study showed that residents of these rural communities

  8. Mental health literacy in rural Queensland: results of a community survey.

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    Bartlett, Helen; Travers, Catherine; Cartwright, Colleen; Smith, Norman

    2006-09-01

    The aim of this study was to assess the awareness of, and attitudes to, mental health issues in rural dwelling Queensland residents. A secondary objective was to provide baseline data of mental health literacy prior to the implementation of Australian Integrated Mental Health Initiative--a health promotion strategy aimed at improving the health outcomes of people with chronic or recurring mental disorders. In 2004 a random sample of 2% (2132) of the estimated adult population in each of eight towns in rural Queensland was sent a postal survey and invited to participate in the project. A series of questions were asked based on a vignette describing a person suffering major depression. In addition, questions assessed respondents' awareness and perceptions of community mental health agencies. Approximately one-third (36%) of those surveyed completed and returned the questionnaire. While a higher proportion of respondents (81%) correctly identified and labelled the problem in the vignette as depression than previously reported in Australian community surveys, the majority of respondents (66%) underestimated the prevalence of mental health problems in the community. Furthermore, a substantial number of respondents (37%) were unaware of agencies in their community to assist people with mental health issues while a majority of respondents (57.6%) considered that the services offered by those agencies were poor. While mental health literacy in rural Queensland appears to be comparable to other Australian regions, several gaps in knowledge were identified. This is in spite of recent widespread coverage of depression in the media and thus, there is a continuing need for mental health education in rural Queensland.

  9. Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

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    Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

    2015-09-01

    The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

  10. Perceived barriers and enablers to participation in a community-tailored physical activity program with Indigenous Australians in a regional and rural setting: a qualitative study.

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    Sushames, Ashleigh; Engelberg, Terry; Gebel, Klaus

    2017-09-18

    Aboriginal and Torres Strait Islander people have higher rates of chronic disease and a lower life expectancy than non-Indigenous Australians. In non-urban areas these health disparities are even larger. The aim of this qualitative study was to explore perceived barriers and enablers to attending an eight-week physical activity program in a rural and regional setting which aimed to improve health outcomes, but had a low attendance rate. Thirty-four Indigenous Australians participated in the intervention from the rural (n = 12) and the regional (n = 22) community. Qualitative semi-structured individual interviews were conducted at the follow-up health assessments with 12 participants. A thematic network analysis was undertaken to examine the barriers and enablers to participation in the program. Overall, there were positive attitudes to, and high levels of motivation towards, the physical activity program. Enablers to participation were the inclusion of family members, no financial cost and a good relationship with the principal investigator, which was strengthened by the community-based participatory approach to the program design. Barriers to program attendance were mostly beyond the control of the individuals, such as 'sorry business', needing to travel away from the community and lack of community infrastructure. More consideration is needed prior to implementation of programs to understand how community-specific barriers and enablers will affect attendance to the program. ACTRN12616000497404 . Registered 18 April 2016.

  11. Ruralization of students' horizons: insights into Australian health professional students' rural and remote placements.

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    Smith, Tony; Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

    2018-01-01

    Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students' future rural practice intentions. Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. The core concept identified from the thematic analysis was "ruralization of students' horizons," a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, "preparation and support," "rural or remote health experience," and "rural lifestyle and socialization," each of which includes multiple subthemes. From the content analysis, factors that promoted students' rural practice intentions were having a "positive" practice experience, interactions with "supportive staff," and interactions with the "community" in general. It was apparent that "difficulties," eg, with "accommodation," "Internet" access, "transport," and "financial" support, negatively impacted students' placement experience and rural practice intentions. The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and

  12. Fostering resilience: Empowering rural communities in the face of hardship

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    Darryl Maybery

    2010-11-01

    Full Text Available Australian rural communities are experiencing some of the worst climactic and economic conditions in decades. Unfortunately, the multiple government and non-government agency responses have reportedly been uncoordinated, sometimes losing sight of their consumers. This article describes a program designed to strengthen and empower resilience in small rural communities and summarises the outcomes, including needs and action planning undertaken. The 97 participants were from eight outer regional or remote towns and communities in the northern Riverina region of New South Wales, Australia. As groups representing their communities, they attended meetings and responded to a series of questions regarding issues arising from the drought, community needs, and actions their community could take to address these issues and needs. The study findings highlight the stress and strain of the climatic conditions and the insecurity of rural incomes, as well as problems with the high cost of transport. The communities recognised a degree of social disintegration but also expressed considerable hope that, by working together and better utilising social agencies, they could develop a social connectedness that would make their communities more resilient. Approaches that empower and facilitate community resilience are suggested as an effective model that governments and non-government agencies can use to encourage social groups that are struggling to build resilience.

  13. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

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    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  14. Factors affecting rural volunteering in palliative care - an integrated review.

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    Whittall, Dawn; Lee, Susan; O'Connor, Margaret

    2016-12-01

    To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment

  15. Homeopathy in rural Australian primary health care: a survey of general practitioner referral and practice in rural and regional New South Wales, Australia.

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    Wardle, J; Adams, J; Sibbritt, D

    2013-07-01

    Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  16. The Australian Telecentre Program: A New Approach to Technology Transfer and Rural Community Development.

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    Crellin, Ian R.

    Telecottages originated in Scandinavia in the 1980s in an attempt to reverse the decline of isolated communities by giving them access to information and services, facilities for training and distance education, and the opportunity to produce income through telecommuting. In 1992-1993, the Australian government began funding the Telecentre…

  17. The Internet & Regional Australia: How Rural Communities Can Address the Impact of the Internet.

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    Simpson, Rosie

    In the last decade, a technological revolution has touched all aspects of business and society in Australia, the Western world, and to a lesser extent, the developing world. This revolution has occurred against a backdrop of long-term fundamental changes in rural Australian communities. The decline in traditional agriculture's terms of trade and…

  18. Implementing an anti-smoking program in rural-remote communities: challenges and strategies.

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    Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C

    2015-01-01

    Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

  19. "It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study.

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    Passey, Megan E; Gale, Jennifer T; Sanson-Fisher, Robert W

    2011-12-09

    Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge

  20. "It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study

    Directory of Open Access Journals (Sweden)

    Passey Megan E

    2011-12-01

    Full Text Available Abstract Background Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. Methods We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Results Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. Conclusions The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation

  1. The role of extension in building capacity and resilience in Australian rural industries

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    Hunt, Warren

    2014-01-01

    This thesis investigates the evolution of Australian agricultural extension services since the 19th Century and how it has transitioned over time. It defines the concepts of capacity and resilience building in an Australian rural context, and provides two case studies that explain how capacity and

  2. An empirical approach to selecting community-based alcohol interventions: combining research evidence, rural community views and professional opinion

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    Shakeshaft Anthony

    2012-01-01

    Full Text Available Abstract Background Given limited research evidence for community-based alcohol interventions, this study examines the intervention preferences of rural communities and alcohol professionals, and factors that influence their choices. Method Community preferences were identified by a survey of randomly selected individuals across 20 regional Australian communities. The preferences of alcohol professionals were identified by a survey of randomly selected members of the Australasian Professional Society on Alcohol and Other Drugs. To identify preferred interventions and the extent of support for them, a budget allocation exercise was embedded in both surveys, asking respondents to allocate a given budget to different interventions. Tobit regression models were estimated to identify the characteristics that explain differences in intervention preferences. Results Community respondents selected school programs most often (88.0% and allocated it the largest proportion of funds, followed by promotion of safer drinking (71.3%, community programs (61.4% and police enforcement of alcohol laws (60.4%. Professionals selected GP training most often (61.0% and allocated it the largest proportion of funds, followed by school programs (36.6%, community programs (33.8% and promotion of safer drinking (31.7%. Community views were susceptible to response bias. There were no significant predictors of professionals' preferences. Conclusions In the absence of sufficient research evidence for effective community-based alcohol interventions, rural communities and professionals both strongly support school programs, promotion of safer drinking and community programs. Rural communities also supported police enforcement of alcohol laws and professionals supported GP training. The impact of a combination of these strategies needs to be rigorously evaluated.

  3. Australian Rural Accountants' Views on How Locally Provided CPD Compares with City-Based Provision

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    Halabi, Abdel K.

    2015-01-01

    This paper analyses Australian rural accountants' attitudes and levels of satisfaction with continuing professional development (CPD), based on whether the CPD was delivered by a professional accounting body in a rural or metropolitan area. The paper responds to prior research that finds rural accountants are dissatisfied with professional…

  4. Examining the Average Citation Index of "Education in Rural Australia" (Now the "Australian and International Journal of Rural Education")

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    Drummond, Aaron; Halsey, R. John

    2013-01-01

    The journal "Education in Rural Australia" (now the "Australian and International Journal of Rural Education") has been in existence since 1991. During the Excellence in Research Australia (ERA) period, the journal maintained a B ranking, indicating that it was a quality journal within a specialised field. With the abolishment…

  5. Rural Australian community pharmacists' views on complementary and alternative medicine: a pilot study

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    Willis Jon A

    2011-10-01

    Full Text Available Abstract Background Complementary and alternative medicines (CAMs are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study. Methods A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics. Results Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books. Conclusions Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to

  6. Challenges to student transition in allied health undergraduate education in the Australian rural and remote context: a synthesis of barriers and enablers.

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    Spiers, M C; Harris, M

    2015-01-01

    The optimum supply of an allied health workforce in rural and remote communities is a persistent challenge. Despite previous indicative research and government investment, the primary focus for rural and remote recruitment has been on the medical profession. The consequent shortage of allied health professionals leaves these communities less able to receive appropriate health care. This comprehensive review incorporates a literature analysis while articulating policy and further research implications. The objective was to identify drivers to recruitment and retention of an allied health workforce in rural and remote communities. This issue was observed in two parts: identification of barriers and enablers for students accessing allied health undergraduate tertiary education, and barriers and enablers to clinical placement experience in rural and remote communities. A search of empirical literature was conducted together with review of theoretical publications, including public health strategies and policy documents. Database searches of CINAHL, Medline, ERIC, PsychInfo and Scopus were performed. Selection criteria included Australian research in English, full text online, keywords in title or abstract, year of publication 1990 to 2012 and research inclusive of rural and remote context by application of the Australian Standard Geographical Classication (ASGC) Remoteness Structure. Theoretical publications, or grey literature, were identified by broad Google searches utilising a variety of search terms relevant to the review objective. Allied health professions were defined as including audiology, dietetics, occupational therapy, optometry, orthoptics, orthotics and prosthetics, pharmacy, physiotherapy, podiatry, psychology, radiography, social work, speech pathology and Aboriginal and Torres Strait Islander Health Workers. A total of 28 empirical publications met the selection criteria with a further 22 grey literature texts identified with relevance to the research

  7. Riding the rural radio wave: The impact of a community-led drug and alcohol radio advertising campaign in a remote Australian Aboriginal community.

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    Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Snijder, Mieke

    2017-10-01

    Aboriginal people experience a higher burden of disease as a consequence of drug and alcohol (D&A) abuse. Although media campaigns can be a popular tool for disseminating health promotion messages, evidence of the extent to which they reduce the impact of substance abuse is limited, especially for rural Aboriginal communities. This paper is the first to examine the impact a locally designed D&A radio advertising campaign for Aboriginal people in a remote community in Western NSW. A post-intervention evaluation. The radio campaign was implemented in Bourke, (population 2465, 30% Aboriginal). Fifty-three community surveys were completed. The self-reported level of awareness of the campaign and the number of self-referrals to local D&A workers in the intervention period. Most respondents (79%) reported they listen to radio on a daily basis, with 75% reporting that they had heard one or more of the advertisements. The advertisement that was remembered best contained the voice of a respected, local person. There was one self-referral to local health services during the intervention timeframe. The community-led radio advertising campaign increased community awareness of substance abuse harms, but had limited impact on formal help-seeking. This paper highlights the value of radio as a commonly used, trusted and culturally relevant health promotion medium for rural communities, especially when engaging local respected Aboriginal presenters. © 2017 National Rural Health Alliance Inc.

  8. Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements

    Science.gov (United States)

    Cross, Merylin; Waller, Susan; Chambers, Helen; Farthing, Annie; Barraclough, Frances; Pit, Sabrina W; Sutton, Keith; Muyambi, Kuda; King, Stephanie; Anderson, Jessie

    2018-01-01

    Introduction Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study

  9. Toka Boot/The Big Jam: Making Music in Rural East Timor

    Science.gov (United States)

    Howell, Gillian; Dunphy, Kim

    2012-01-01

    This article discusses a community music project in rural East Timor. Australian musician Gillian Howell lived for three months in the isolated town of Lospalos as an Asialink artist-in-residence, where she worked with local community members and visiting Australian musicians to share music and ideas, and to communicate across cultures. Three…

  10. Learning Preferences and Impacts of Education Programs in Dog Health Programs in Five Rural and Remote Australian Indigenous Communities

    Science.gov (United States)

    Constable, Sophie; Dixon, Roselyn; Dixon, Robert

    2011-01-01

    As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…

  11. Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

    Science.gov (United States)

    Malatzky, Christina; Bourke, Lisa

    2018-05-25

    To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

  12. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  13. A long way from home: Access to cancer care for rural Australians

    International Nuclear Information System (INIS)

    Smith, Tony

    2012-01-01

    In 2002, the Commonwealth Radiation Oncology Inquiry reported that access to cancer care services in Australia was seriously limited. Several recommendations were made, including improving access to cancer care in rural areas by increasing the number of comprehensive oncology facilities outside the cities. Much has changed since 2002, with the establishment of a number of Regional Integrated Cancer Centres. This has been boosted again in 2011 by further Commonwealth Government funding. Cancer is primarily a disease of the elderly and, with the ageing population access to cancer care for rural and remote Australians remains a major challenge. Cancer is the second most common cause of death in Australia, exceeded only by cardiovascular disease. It has been reported that the relative risk of dying of cancer within 5 years of diagnosis is 35% higher for those living in remote locations compared with major cities. Overall cancer mortality is significantly higher in rural and remote locations (206 deaths per 100,000) compared with urbanised areas (172 per 100,000). Cancer mortality is higher again for the Aboriginal population (230 per 100,000). The reasons for the disparity in cancer outcomes for metropolitan versus non-metropolitan Australians are varied. In general, rural and remote residents have to travel long distances and stay away from home, family and work for long periods of time to access the care they need. Hence, distance is the overriding barrier to access, compounded by the financial costs and disruption to family life, not to mention the endemic lack of specialist medical and allied health workforce outside the major cities. Some rural and remote Australians choose to compromise, accessing whatever care they can locally, although this contributes to the need for cancer care services close to where people choose to live and die, to deal with the complex associated morbidities. Recent government investment in new regional cancer care infrastructure is

  14. Suicide among young rural Australians 1964-1993: a comparison with metropolitan trends.

    Science.gov (United States)

    Dudley, M; Kelk, N; Florio, T; Howard, J; Waters, B; Haski, C; Alcock, M

    1997-07-01

    The study tested hypotheses that from 1964 to 1993: (1) suicide rates among Australian 15- to 24-year-old males rose more sharply in rural than metropolitan areas; (2) firearm suicide rates among 15- to 24-year-old males, declining throughout Australia recently, rose continuously in rural areas; (3) suicide rates among 15- to 24-year-old females did not change significantly in either metropolitan or rural areas. Suicides of those aged 10-24 years recorded by the Australian Bureau of Statistics (ABS) were classified according to the subject's residential grouping. Rates were calculated using ABS population data corresponding to these groupings. Results were analysed using log-linear analysis and chi-square statistics. The results supported the first two hypotheses, but not the third. Suicide rates for 15- to 24-year-old males rose by a factor of 2.2 in metropolitan areas, by 4-fold in towns with populations between 4,000 and 25,000, and by 12-fold in towns with populations less than 4,000. Male firearm suicide rates continued to rise in rural areas, and the greatest proportion of deaths in those locations were by firearms, though male hanging rates increased most in recent years in all locations. Female youth suicide rates did not change overall, but in towns with populations less than 4,000, they increased 4.5-fold. Possible explanations for this epidemic, which are mostly speculative and require confirmation, are discussed.

  15. Olivebranches and idiot's guides: Frameworks for community engagement in Australian wind farm development

    International Nuclear Information System (INIS)

    Howard, Tanya

    2015-01-01

    In Australia, renewable energy is under pressure in the context of a highly politicised debate about how to act on climate change. The recent repeal of an established carbon tax has seen the defunding of significant renewable energy initiatives and a controversial review of the national Renewable Energy Target is threatening key drivers for investment in renewable energy. The current regulatory focus on community ‘acceptance’ does not facilitate the active community support necessary to challenge this increasingly hostile policy context. This research considers current experiences of community engagement in wind farm governance in one Australian jurisdiction. Through documentary analysis and two qualitative case studies, it examines legal and non-legal requirements for community governance mechanisms and considers how these influence wind farm development in rural areas. Findings include a problematic reliance on procedural compliance in assessing wind farm consultation, domination by vested interests, and reduced expertise in community engagement at the time it is needed most. Recommendations include integration of best practice guidelines in current regulation; harmonisation of policy settings to ensure equity across energy sectors; and an evidence-based commitment to benefit sharing as a strategy for increasing community support of rural wind farm development. - Highlights: • Changes to renewable energy policy in Australia threaten wind farm development. • Active community support is required to ensure ongoing viability of the industry. • Benefit sharing models are shown to increase community support for wind farms. • Legal frameworks reinforce a minimum compliance paradigm and entrench vested interests. • Best practice guidelines improve implementation of community engagement procedures

  16. Municipal service provision in rural communities

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... hierarchies and considering local resources and place bound potentials.  This paper draws on a study of rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are managed by rural municipalities and local communities. The paper further discusses whether rural...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....

  17. A Place to Learn: Cultivating Engaging Learning Environments for Young Rural Aboriginal Australians

    Science.gov (United States)

    Tracey, Danielle; Craven, Rhonda G.; Yeung, Alexander Seeshing; Tregeagle, Susan; Burnstein, Jodi; Stanley, Helena

    2016-01-01

    Rural Aboriginal Australians experience disadvantage across a number of significant social and economic outcomes, including educational engagement and achievement. Current debate postulates that educational environments and systems perpetuate this disadvantage. This qualitative study aimed to contribute to the debate by taking a broader ecological…

  18. Understanding Australian rural women's ways of achieving health and wellbeing - a metasynthesis of the literature.

    Science.gov (United States)

    Harvey, Desley J

    2007-01-01

    Although Australian rural women appear to be coping well despite a lack of services, harsh environmental conditions and overall rural health disadvantage, there is little research into the factors which promote good health among them. The aim of this article is to document and analyse current understandings about how rural Australian women maintain health and wellbeing, by conducting a metasynthesis of peer reviewed empirical qualitative research. Searches were conducted of CINAHL, MEDLINE, Proquest, Blackwell Synergy, Informit, Infotrac, National Rural Health Alliance and Indigenous Health Infonet data bases. A definition of health and wellbeing as a positive concept emphasising social and personal resources as well as physical capacities, provided a framework for the review. Six studies published in rural health, nursing and sociology journals between 2001 and 2006 were selected. Common and recurring themes from the original studies were identified. Reciprocal translation was used to synthesise the findings among the studies, leading to interpretations beyond those identified in the original studies. Four themes emerged from the metasynthesis: isolation, belonging, coping with adversity, and rural identity. The findings of this study exhibit a tension between a sense of belonging and the experience of social and geographical isolation. The study findings also reveal tension between adherence to a strong gendered rural identity which fosters a culture of stoicism and self reliance and feelings of resistance to societal expectations of coping with adversity. Metasynthesis enabled a deeper understanding of the health and wellbeing of rural women in Australia. The social experiences of rural women influence the way they construe their health and wellbeing. Understanding how women maintain health and wellbeing is critical in ensuring that policies and services meet the needs of rural women and do not entrench existing inequalities.

  19. Regional Differences in Correlates of Daily Walking among Middle Age and Older Australian Rural Adults: Implications for Health Promotion

    Directory of Open Access Journals (Sweden)

    James Dollman

    2016-01-01

    Full Text Available Rural Australians are less physically active than their metropolitan counterparts, and yet very little is known of the candidate intervention targets for promoting physical activity in rural populations. As rural regions are economically, socially and environmentally diverse, drivers of regular physical activity are likely to vary between regions. This study explored the region-specific correlates of daily walking among middle age and older adults in rural regions with contrasting dominant primary industries. Participants were recruited through print and electronic media, primary care settings and community organisations. Pedometers were worn by 153 adults for at least four days, including a weekend day. A questionnaire identified potential intra-personal, social and environmental correlates of physical activity, according to a social ecological framework. Regression modelling identified independent correlates of daily walking separately in the two study regions. In one region, there were independent correlates of walking from all levels of the social ecological framework. In the other region, significant correlates of daily walking were almost all demographic (age, education and marital status. Participants living alone were less likely to be physically active regardless of region. This study highlights the importance of considering region-specific factors when designing strategies for promoting regular walking among rural adults.

  20. Carbon profiles of remote Australian Indigenous communities: A base for opportunities

    International Nuclear Information System (INIS)

    Stewart, J.; Anda, M.; Harper, R.J.

    2016-01-01

    A decision-making model was constructed to assist remote Australian Indigenous communities select appropriate climate change mitigation programs. The Resilient Community and Livelihood Asset Integration Model (ReCLAIM) comprises six steps that focus on community assets and aspirations. The second of these steps is to determine the baseline carbon profiles of communities based on six sources of carbon emissions: materials, construction processes, stationary energy, transport, water systems and waste. The methodology employed an annualised lifecycle analysis of housing materials and construction, and an annual inventory of other emission sources. Profiles were calculated for two remote communities and compared to the Australian average and also average electricity consumption by remote communities in the Northern Territory. The results, expressed in tonnes of carbon dioxide equivalent (tCO_2-e), showed that average household carbon profiles of the two communities (6.3 and 4.1 tCO_2-e/capita/yr) were generally lower than the Australian average (7.3 tCO_2-e/capita/yr). The stationary energy results revealed that infrastructure and building design could raise fuel consumption and costs, and therefore carbon emissions, despite modest lifestyles. The carbon emission categories differed between the two communities highlighting the need for an individualised approach to understanding the drivers of carbon emissions and mitigation responses. - Highlights: •We model carbon profiles of two remote Aboriginal communities. •Community carbon profiles were lower than the Australian average. •We compare stationary energy with a 72-community sample average. •Low-carbon communities are possible with renewable energy systems. •Building design and energy source can impact significantly on emissions.

  1. Rural men's subjective well-being and the role of social support and sense of community: evidence for the potential benefit of enhancing informal networks.

    Science.gov (United States)

    Kutek, Stephanie M; Turnbull, Deborah; Fairweather-Schmidt, A Kate

    2011-02-01

    To examine the effects of social support and sense of community on rural men's subjective well-being, considering the main effects and stress-buffer models. Cross-sectional population-based survey, non-probability sampling frame primarily convenience sampling. Community-based setting. A total of 185 men aged 18+ years from rural South Australia. Subjective well-being, measured by the Satisfaction With Life Scale. Two-step hierarchical multiple regression analysis was conducted, with subjective well-being as the dependent variable, controlling for independent variables of age, living alone and farm employment. Social support was the most effective predictor of well-being, followed by stress, and only a very modest contribution from sense of community; total variance explained was 56% (F(6,178) = 37.77, P well-being and sense of community/well-being relationships (mediation analysis). Results demonstrated the benefits of social support on well-being using the stress-buffer and main effects models, within a sample of rural men, and explored the relatively unexamined relationship between sense of community and well-being. Rural men have considerable stress impacting their well-being. This study identifies that it is critical for individuals, organisations and policy makers to be aware of the capacity of both social supports and sense of community to buffer stress and promote well-being within rural men. Furthermore, structural, community-based approaches might have greater capacity to cost-effectively provide this support, contrasting with the growing trend towards individual-based approaches for mental health. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  2. The vulnerability of Australian rural communities to climate variability and change: Part I—Conceptualising and measuring vulnerability

    NARCIS (Netherlands)

    Nelson, R.; Kokic, P.; Crimp, S.; Meinke, H.B.; Howden, S.M.

    2010-01-01

    Vulnerability is a term frequently used to describe the potential threat to rural communities posed by climate variability and change. Despite growing use of the term, analytical measures of vulnerability that are useful for prioritising and evaluating policy responses are yet to evolve. Demand for

  3. Psychological Sense of Community: An Australian Aboriginal Experience

    Science.gov (United States)

    Bishop, Brian; Colquhoun, Simon; Johnson, Gemma

    2006-01-01

    Sense of community (SOC) is central to an individual's psychological wellbeing (Sarason, 1974). Eleven participants, mainly from the North West of Western Australia, took part in semistructured interviews investigating Australian Aboriginal notions of community and SOC. Five key themes emerged from the data. These included: kinship structure,…

  4. Assessing Rural Communities through Youth Photography

    Directory of Open Access Journals (Sweden)

    Renee A. Oscarson

    2012-06-01

    Full Text Available Despite frequent concerns about youth and young adult migration from rural to urban areas, most measures used to assess youth in rural community research have been developed by adults. Accurate understanding of youth community perceptions necessitates youth input into the research process. The participatory research strategy described here, using photography to describe community, enables youth to define community and identify what they value about their communities. Photographs and explanations of the photographs indicated that youth value places (schools, churches, as well as locations unique to communities and people from those communities. Photovoice, photography-based participatory-action research, is a feasible and engaging method for obtaining youth perspectives on community issues. Further, Photovoice may be adapted to the needs of different age groups and situations.

  5. Community participation in rural health: a scoping review

    Directory of Open Access Journals (Sweden)

    Kenny Amanda

    2013-02-01

    Full Text Available Abstract Background Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare. Methods A scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results We identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured. Conclusions In an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for

  6. Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia.

    Science.gov (United States)

    Medlin, Linda G; Chang, Anne B; Fong, Kwun; Jackson, Rebecca; Bishop, Penny; Dent, Annette; Hill, Deb C; Vincent, Stephen; O'Grady, Kerry-Ann F

    2014-09-01

    Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia.

  7. Older Chinese-Australian and Chinese community music engagement

    OpenAIRE

    Li, Sicong

    2017-01-01

    This research study will investigate community music engagement by both Chinese-Australians and Chinese older people at two different older people’s organizations with the aim of exploring the affects of music engagement on older people. The study seeks to explore cultural differences between Chinese-Australian older people and Chinese older people as they relate to their music engagement. The research contentions were that (1) active music engagement can enhance the quality of the life of ol...

  8. A Community Standard: Equivalency of Healthcare in Australian Immigration Detention.

    Science.gov (United States)

    Essex, Ryan

    2017-08-01

    The Australian government has long maintained that the standard of healthcare provided in its immigration detention centres is broadly comparable with health services available within the Australian community. Drawing on the literature from prison healthcare, this article examines (1) whether the principle of equivalency is being applied in Australian immigration detention and (2) whether this standard of care is achievable given Australia's current policies. This article argues that the principle of equivalency is not being applied and that this standard of health and healthcare will remain unachievable in Australian immigration detention without significant reform. Alternate approaches to addressing the well documented issues related to health and healthcare in Australian immigration detention are discussed.

  9. Rural Community Development: Bedrock for National Development ...

    African Journals Online (AJOL)

    This paper advocates that community development is the bedrock for national development. For any meaningful development to take place, whether national or global development must have its building blocks or firm-root in rural development. However, the rural communities are characterized by isolation from ideas and ...

  10. Community resiliency as a measure of collective health status: perspectives from rural communities.

    Science.gov (United States)

    Kulig, Judith C; Edge, Dana; Joyce, Brenda

    2008-12-01

    Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.

  11. An Australian Indigenous community-led suicide intervention skills training program: community consultation findings.

    Science.gov (United States)

    Nasir, Bushra; Kisely, Steve; Hides, Leanne; Ranmuthugala, Geetha; Brennan-Olsen, Sharon; Nicholson, Geoffrey C; Gill, Neeraj S; Hayman, Noel; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree

    2017-06-13

    Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.

  12. Reducing cancer risk in rural communities through supermarket interventions.

    Science.gov (United States)

    McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M

    2013-09-01

    Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.

  13. Australian rural radiographers' perspectives on disclosure of their radiographic opinion to patients

    International Nuclear Information System (INIS)

    Squibb, Kathryn; Bull, Rosalind M.; Smith, Anthony; Dalton, Lisa

    2015-01-01

    The role of Australian rural radiographers in radiographic interpretation, communication and disclosure of their radiographic opinion with a specific focus on plain film radiography was examined in a two phase, exploratory interpretive study. Data were collected using questionnaires and interviews and analysed thematically. This reports one of the key themes identified in the thematic data analysis. ‘Disclosure of Radiographic Opinion to Patients’ comprises the three interrelated sub-themes Acting Ethically, Selective Disclosure and Filtered Truth. It is wholly concerned with the ways in which rural radiographers choose to disclose their radiographic opinion to patients. Without a clear picture of where they stand medico-legally, rural radiographers draw on experience and a strong ethical framework as the basis for these complex decisions. Rural radiographers frame their disclosures to patients in a manner that is governed by the diagnostic, therapeutic and emotional impact the information disclosed may have on the patient. Disclosure to patients was found to be selective, often diagnostically vague and ethically filtered

  14. Recruitment and retention of home support workers in rural communities.

    Science.gov (United States)

    Sharman, Zena

    2014-01-01

    This qualitative study examined recruitment and retention of home support workers (HSWs) providing home support in rural communities. Thirty-two participants were recruited across four island-based communities located in British Columbia, Canada. Thematic analysis of interview data revealed several key themes: (a) how the rural context shapes HSWs' employment decisions and opportunities; (b) why people become (and stay) HSWs in rural communities; and (c) how rurality influences the nature and scope of HSWs' work. These findings suggest that health human resource policies and programs aimed at HSW recruitment and retention should be tailored to characteristics, strengths, and challenges of rural communities.

  15. Community Satisfaction in Czech Rural Communities: A Multilevel Model

    Czech Academy of Sciences Publication Activity Database

    Bernard, Josef

    2015-01-01

    Roč. 55, č. 2 (2015), s. 205-226 ISSN 0038-0199 Institutional support: RVO:68378025 Keywords : community satisfaction * rural communities * contextual effects Subject RIV: AO - Sociology , Demography Impact factor: 1.380, year: 2015

  16. Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.

    Science.gov (United States)

    Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana

    2007-09-01

    In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure

  17. Post-traumatic stress disorder symptoms in pregnant Australian Indigenous women residing in rural and remote New South Wales: A cross-sectional descriptive study.

    Science.gov (United States)

    Mah, Beth; Weatherall, Loretta; Burrows, Julie; Blackwell, Caroline C; Gwynn, Josephine; Wadhwa, Pathik; Lumbers, Eugenie R; Smith, Roger; Rae, Kym M

    2017-10-01

    Pregnancy can be a stressful time for many women. There is ample evidence of numerous physical and mental health inequities for Indigenous Australians. For those Indigenous women who are pregnant, it is established that there is a higher incidence of poor physical perinatal outcomes when compared with non-Indigenous Australians. However, little evidence exists that examines stressful events and post-traumatic stress disorder (PTSD) symptoms in pregnant women who are members of this community. To quantify the rates of stressful events and PTSD symptoms in pregnant Indigenous women. One hundred and fifty rural and remote Indigenous women were invited to complete a survey during each trimester of their pregnancy. The survey measures were the stressful life events and the Impact of Events Scale. Extremely high rates of PTSD symptoms were reported by participants. Approximately 40% of this group exhibited PTSD symptoms during their pregnancy with mean score 33.38 (SD = 14.37) significantly higher than a study of European victims of crisis, including terrorism attacks (20.6, SD = 18.5). The extreme levels of PTSD symptoms found in the women participating in this study are likely to result in negative implications for both mother and infant. An urgent response must be mounted at government, health, community development and research levels to address these findings. Immediate attention needs to focus on the development of interventions to address the high levels of PTSD symptoms that pregnant Australian Indigenous women experience. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  18. Faecal incontinence in rural and regional northern Queensland community-dwelling adults.

    Science.gov (United States)

    Bartlett, Lynne M; Nowak, Madeleine J; Ho, Yikhong

    2013-01-01

    In Australia, faecal incontinence, the involuntary loss of liquid or solid stool with or without a person's awareness, has been reported in 8% of the South Australian and 11% of the urban New South Wales community-dwelling populations. Studies conducted in 2004 and 2005 reported faecal incontinence in more than 20% of colorectal and urogynaecological clinic patients at Townsville Hospital (a referral centre serving rural North Queensland). This prompted concern regarding the level of faecal incontinence in the community. The aim of this study was to investigate the prevalence of faecal incontinence in the North and Far North Queensland urban and rural communities. The sample size was based on the New South Wales postal surveys (11% prevalence). Higher rates were expected in North/Far North Queensland, so prevalence there was estimated at 12.1% (confidence interval ± 2%, ie the true level to be between 10.1% and 14.1%). The sample for each of the Townsville, Cairns (in Far North Queensland) and rural/remote settings was calculated at 1022. The database for the present study was compiled using a systematic randomised process selecting two private names from each column on each page of the Cairns and Townsville White Pages® (Cairns: 1112 urban, 481 rural, 226 remote; Townsville: 1049 urban, 432 rural, 320 remote). The questionnaire covered personal demographics, health/risk factors, bowel habits, nutrition (fibre and fluid intake) and physical activity. Faecal incontinence was defined as accidental leakage of solid or liquid stool in the past 12 months that was not caused by a virus, medication or contaminated food. To improve the response rate a participation incentive of a chance to win a $250 voucher or one of ten $50 vouchers was offered in the initial mail-out. The initial survey was mailed out in July 2007; two follow-up surveys were mailed out to non-responders in September 2007 and January 2008. One hundred randomly selected non-responders were telephoned in

  19. Establishment of an innovative specialist cardiac indigenous outreach service in rural and remote Queensland.

    Science.gov (United States)

    Tibby, David; Corpus, Rohan; Walters, Darren L

    2010-01-01

    Cardiovascular diseases are the leading cause of mortality in Indigenous Australians. Indigneous Australians present at a younger age and have a greater incidence of cardiac risk including smoking and diabetes than non-Indigenous Australians. Access to specialist health services is an important determinant of health care outcomes for these patients. We describe an innovative and successful for model for providing Outreach Cardiac Specialist services to Indigenous communities in rural and remote locations. The approach involves a step-wise process of a) community engagement, b) delivering recovery interventions to improve health outcomes, c) building community capacity to self manage chronic illness and promoting health and well being with the aim of d) community self governance of chronic disease and health promotion. Key elements to this process are community participation in the program, disease self-management led by local health care workers, open access that is all-inclusive utilising community-generated referral, and the translation of scientific knowledge of disease processes into community understanding and making culturally relevant connections. Specialist cardiac services and point of care diagnostics have been provided to 18 sites across rural and remote Queensland. More than 1400 episodes of care have been provided to Indigenous Australians with rheumatic heart disease, ischaemic heart disease and congenital heart conditions. Traditional values can work harmoniously with an inclusive medical approach in this relational model. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

  20. A controlled community-based trial to promote smoke-free policy in rural communities.

    Science.gov (United States)

    Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah; Begley, Kathy; York, Nancy

    2015-01-01

    Rural, tobacco-growing areas are disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies. The purpose was to test the effects of a stage-specific, tailored policy-focused intervention on readiness for smoke-free policy, and policy outcomes in rural underserved communities. A controlled community-based trial including 37 rural counties. Data were collected annually with community advocates (n = 330) and elected officials (n = 158) in 19 intervention counties and 18 comparison counties over 5 years (average response rate = 68%). Intervention communities received policy development strategies from community advisors tailored to their stage of readiness and designed to build capacity, build demand, and translate and disseminate science. Policy outcomes were tracked over 5 years. Communities receiving the stage-specific, tailored intervention had higher overall community readiness scores and better policy outcomes than the comparison counties, controlling for county-level smoking rate, population size, and education. Nearly one-third of the intervention counties adopted smoke-free laws covering restaurants, bars, and all workplaces compared to none of the comparison counties. The stage-specific, tailored policy-focused intervention acted as a value-added resource to local smoke-free campaigns by promoting readiness for policy, as well as actual policy change in rural communities. Although actual policy change and percent covered by the policies were modest, these areas need additional resources and efforts to build capacity, build demand, and translate and disseminate science in order to accelerate smoke-free policy change and reduce the enormous toll from tobacco in these high-risk communities. © 2014 National Rural Health Association.

  1. Critical Optimism: Reimagining Rural Communities through Libraries

    Directory of Open Access Journals (Sweden)

    Margo Gustina

    2018-04-01

    Full Text Available In Brief: In the absence of governmental agencies and philanthropic support, many rural communities see their local library as the last civic, cultural, or service organization in town. This reality presents obvious challenges to the librarian, and also incredible opportunity. As the primary convener, libraries have the ability to facilitate regeneration in the communities they serve. This article situates rural librarianship within an organizing framework for change and discusses applications of community engagement tools and measures of impact aligned with social wellbeing.

  2. Factors influencing early retirement intentions in Australian rural general practitioners.

    Science.gov (United States)

    Pit, S W; Hansen, V

    2014-06-01

    The Australian general practice workforce is ageing. This and a trend towards higher exit intentions and earlier retirement make it increasingly important to identify those work and personal factors affecting intention to leave, which are amenable to change. To assess the various work, occupational and individual health factors associated with early retirement intentions among Australian rural general practitioners (GPs) that may be amenable to intervention. A cross-sectional study of GPs practising in rural Australia. Odds ratios of early retirement intentions across work, occupational and individual health factors were calculated. There were 92 participants (response rate 56%), and 47% of responders intended to retire before 65. GPs with medium to high burnout levels had higher odds of intending to retire. Increased job satisfaction and work ability scores were associated with decreased retirement intentions, whereas increased physical and mental work ability demands were associated with an increase in retirement intentions. Absenteeism was not related to retirement intentions but presenteeism was. GPs reporting any work-related sleep problems were found to have a 3-fold increase in the odds of early retirement intentions. The odds of early retirement intentions also increased with higher psychological distress, worsening general health and longer working hours. From a health policy reform perspective, the greatest impact on reducing early retirement intentions among ageing GPs could potentially be made by intervening in areas of working hours, burnout and work-related sleep issues, followed by job satisfaction, psychological distress, health, general workability and mental and physical work ability. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Understanding Contexts of Family Violence in Rural, Farming Communities: Implications for Rural Women's Health

    Science.gov (United States)

    Wendt, Sarah; Hornosty, Jennie

    2010-01-01

    Research on family violence in rural communities in Australia and Canada has shown that women's experience of family violence is shaped by social and cultural factors. Concern for economic security and inheritance for children, closeness and belonging, and values of family unity and traditional gender roles are factors in rural communities that…

  4. Rural Embedded Assistants for Community Health (REACH) network: first-person accounts in a community-university partnership.

    Science.gov (United States)

    Brown, Louis D; Alter, Theodore R; Brown, Leigh Gordon; Corbin, Marilyn A; Flaherty-Craig, Claire; McPhail, Lindsay G; Nevel, Pauline; Shoop, Kimbra; Sterner, Glenn; Terndrup, Thomas E; Weaver, M Ellen

    2013-03-01

    Community research and action projects undertaken by community-university partnerships can lead to contextually appropriate and sustainable community improvements in rural and urban localities. However, effective implementation is challenging and prone to failure when poorly executed. The current paper seeks to inform rural community-university partnership practice through consideration of first-person accounts from five stakeholders in the Rural Embedded Assistants for Community Health (REACH) Network. The REACH Network is a unique community-university partnership aimed at improving rural health services by identifying, implementing, and evaluating innovative health interventions delivered by local caregivers. The first-person accounts provide an insider's perspective on the nature of collaboration. The unique perspectives identify three critical challenges facing the REACH Network: trust, coordination, and sustainability. Through consideration of the challenges, we identified several strategies for success. We hope readers can learn their own lessons when considering the details of our partnership's efforts to improve the delivery infrastructure for rural healthcare.

  5. Stages of Change, Smoking Behaviour and Readiness to Quit in a Large Sample of Indigenous Australians Living in Eight Remote North Queensland Communities

    Directory of Open Access Journals (Sweden)

    Robyn McDermott

    2013-04-01

    Full Text Available Tobacco smoking is a major health issue for Indigenous Australians, however there are few interventions with demonstrated efficacy in this population. The Transtheoretical Model may provide a useful framework for describing smoking behaviour and assessing readiness to quit, with the aim of developing better interventions. Interviews were conducted with 593 Indigenous Australians in eight rural and remote communities in north Queensland, to examine stages of change and smoking behaviour. Among current smokers, 39.6% and 43.4% were in Precontemplation and Contemplation stages respectively. A further 13.9% were making preparations to quit (Preparation whilst only 3.2% said they were actively trying to quit (Action. When analysed by stage of change, the pattern of smoking-related behaviours conformed to the results of past research using the model. Importantly however, distribution of individuals across the stages opposes those observed in investigations of smoking behaviour in non-Indigenous Australian populations. The Transtheoretical Model can be used to meaningfully classify Indigenous smokers in remote north Queensland according to stages along the behaviour change continuum. Importantly, in this large sample across eight communities, most Indigenous smokers were not making preparations to change their smoking behaviour. This suggests that interventions should focus on promoting movement toward the Preparation and Action stages of change.

  6. Adolescent health: a rural community's approach.

    Science.gov (United States)

    Groft, Jean N; Hagen, Brad; Miller, Nancy K; Cooper, Natalie; Brown, Sharon

    2005-01-01

    Significant health problems encountered in adulthood often have their roots in health behaviours initiated during adolescence. In order to reverse this trend, school and health personnel, as well as parents and other community members working with high school students, need to be aware of the health-related beliefs and choices that guide the behaviours of teenagers. Although a wide variety of research has been conducted on this topic among urban adolescents, less is known about the health beliefs and behaviors of adolescents residing in rural areas, particularly in Canada. In general, rural Canadians are less healthy than their urban counterparts. Building on the knowledge and understanding of their own community, key stakeholders were invited to engage in the design and implementation of a participatory action research project aimed at understanding and improving the health of rural adolescents. A group of parents, teachers, students, school administrators and public health nurses engaged in a participatory action research project to better understand determinants of the health of rural adolescents at a high school in Western Canada. Group members developed and administered a health survey to 288 students from a small rural high school, in an effort to identify areas of concern and interest regarding health practices and beliefs of rural adolescents, and to take action on these identified concerns. Results indicated some interesting but potentially worrying trends in this population. For example, while frequent involvement in a physical activity was noted by 75.9% of participants, close to half of the females (48%) described their body image as 'a little overweight' or 'definitely overweight', and approximately 25.8% of respondents noted that they skipped meals most of the time. Differences between the genders were apparent in several categories. For example, more girls smoked (16.2%) than boys (12.3%), and more males (55.0%) than females (41%) had tried illegal

  7. Work setting, community attachment, and satisfaction among rural and remote nurses.

    Science.gov (United States)

    Kulig, Judith C; Stewart, Norma; Penz, Kelly; Forbes, Dorothy; Morgan, Debra; Emerson, Paige

    2009-01-01

    To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada. Cross-sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample. The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions. Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment. Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.

  8. Improving collected rainwater quality in rural communities.

    Science.gov (United States)

    Garrido, S; Aviles, M; Ramirez, A; Gonzalez, A; Montellano, L; Gonzalez, B; de la Paz, J; Ramirez, R M

    2011-01-01

    The country of Mexico is facing serious problems with water quality and supply for human use and consumption in rural communities, mainly due to topographic and isolation. In Mexico the average annual precipitation is 1,500 cubic kilometers of water, if 3% of that amount were used, 13 million Mexicans could be supplied with drinking water that they currently do not have access. Considering the limited infrastructure and management in rural communities, which do not receive services from the centralized systems of large cities, a modified pilot multi-stage filtration (MMSF) system was designed, developed, and evaluated for treating collected rainwater in three rural communities, Ajuchitlan and Villa Nicolas Zapata (Morelos State) and Xacxamayo (Puebla State). The efficiencies obtained in the treatment system were: colour and turbidity >93%. It is worth mentioning that the water obtained for human use and consumption complies with the Mexican Standard NOM-127-SSA1-1994.

  9. Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand.

    Science.gov (United States)

    Lorga, Thaworn; Aung, Myo Nyein; Naunboonruang, Prissana; Thinuan, Payom; Praipaksin, Nara; Deesakul, Tida; Inwan, Utumporn; Yingtaweesak, Tawatchai; Manokulanan, Pratumpan; Suangkaew, Srisomporn; Payaprom, Apiradee

    2012-01-01

    Diabetes is a growing epidemic in both urban and rural communities worldwide. We aimed to survey fasting plasma glucose (FPG) status and awareness of diabetes in the rural Karen ethnic community. We investigated the predictors of impaired fasting plasma glucose (IFG) status, which would be easily applicable for prevention of diabetes in a rural community. This was a community-based cross-sectional study conducted at Thasongyang, the most north-western district in Thailand. A total of 299 Karen ethnic rural residents were included in the study. FPG, body mass index, and waist circumference were prospectively measured. We assessed the awareness of diabetes and lifestyle-related health behavior with closed questionnaires in a rural community setting. On screening for FPG, 16.72% of the Karen ethnic residents had hyperglycemia: 3.68% in the diabetic range and 13.04% in the prediabetic range respectively. After adjustment for age, sex, and BMI, waist circumference (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.29-9.57), and having a diabetic blood relative (aOR 4.6, CI 1.81-11.71) are significant predictors of IFG status. It is necessary to promote awareness of diabetes among the Karen ethnic community. Application of simple evidence-based predictors of the prediabetic state may lead to timely and effective prevention of diabetes in rural settings.

  10. impacts of alternative farm policies on rural communities

    Science.gov (United States)

    J. Michael Bowker; James W. Richardson

    1989-01-01

    The purpose of this study was to describe an LP/IO model for evaluating the economic impacts of alternative farm policies on rural communities and demonstrate its capabilities by analyzing the impacts of three farm policies on a rural community in Texas. Results indicate that in the noncrop sector, two groups of industries are most affected by farm policy. The first...

  11. Rurality and mental health: an Australian primary care study.

    Science.gov (United States)

    Campbell, A; Manoff, T; Caffery, J

    2006-01-01

    Until recently, there has been a significant gap in the literature exploring the issues of the mental health needs for rural communities in Australia. In this study we investigated the prevalence of diagnosable psychological disorders in both a rural and a non-rural primary care sample in far north Queensland, Australia. In a previous study we had screened some 300 GP attendees, on a number of sociodemographic variables and measures of psychological wellbeing, from four rural GP practices and one regional GP practice. Of these, 130 participants agreed to further follow up. In this study, 118 of the participants were selected and contacted by phone to complete the Composite International Diagnostic Interview-Short Form (CIDI-SF). The CIDI-SF diagnosis was then analysed in relation to the sociodemographic indicators that had previously been collected. The prevalence of diagnosable mental health disorders in the rural sample was found to be higher in comparison with the regional urban sample. The sociodemographic factors of rural residence, gender, and length of residence were associated with having a CIDI-SF diagnosis. Although there were a number of methodological limitations to this study, there did appear to be a significant relationship between rural location and the likelihood of receiving a CIDI-SF diagnosis. Why this might be the case is not clear, and we consider a number of explanations, but our finding suggests that further research in mental health should consider the issue of rurality as a key feature to be explored.

  12. The Attraction of Adjunct Faculty to Rural Community Colleges

    Science.gov (United States)

    Charlier, Hara Dracon

    2010-01-01

    As rural community colleges face mounting fiscal pressure, the ability to attract adjunct faculty members to support the institutional mission becomes increasingly important. Although the professional literature documents differences between rural, suburban, and urban community colleges, the effect of this institutional diversity on the role and…

  13. Rural And Urban Youth Participation In Community Development In ...

    African Journals Online (AJOL)

    The focused on participation in community development activities, constraints to and benefits derived from participation. It compared rural and urban youth participation in community development activities in Ido local government area of Oyo State. Proportionate random sampling was used to select 2 rural, 1 urban ...

  14. Comparison and Research on New Rural Community Management Patterns of Shan Dong Province

    Science.gov (United States)

    Fang, Lei; Zhang, Xiaomei

    Rural community is an important institutional innovation,which has important effect and edification to future new rural management.There are three new rural community management patterns in shandong province:divisions of the village community,many villages community and village merge community. This article not only introduce three models,but also compare them in four aspects: community scale, community management,infrastructure,resource utilization.Pointing out the strength and weakness of three models.Drawing a conclusion that village merge community is the active reaction for rural urbanization. And could be the important recommended breed.

  15. Rural community birth: Maternal and neonatal outcomes for planned community births among rural women in the United States, 2004-2009.

    Science.gov (United States)

    Nethery, Elizabeth; Gordon, Wendy; Bovbjerg, Marit L; Cheyney, Melissa

    2017-11-13

    Approximately 22% of women in the United States live in rural areas with limited access to obstetric care. Despite declines in hospital-based obstetric services in many rural communities, midwifery care at home and in free standing birth centers is available in many rural communities. This study examines maternal and neonatal outcomes among planned home and birth center births attended by midwives, comparing outcomes for rural and nonrural women. Using the Midwives Alliance of North America Statistics Project 2.0 dataset of 18 723 low-risk, planned home, and birth center births, rural women (n = 3737) were compared to nonrural women. Maternal outcomes included mode of delivery (cesarean and instrumental delivery), blood transfusions, severe events, perineal lacerations, or transfer to hospital and a composite (any of the above). The primary neonatal outcome was a composite of early neonatal intensive care unit or hospital admissions (longer than 1 day), and intrapartum or neonatal deaths. Analysis involved multivariable logistic regression, controlling for sociodemographics, antepartum, and intrapartum risk factors. Rural women had different risk profiles relative to nonrural women and reduced risk of adverse maternal and neonatal outcomes in bivariable analyses. However, after adjusting for risk factors and confounders, there were no significant differences for a composite of maternal (adjusted odds ratio [aOR] 1.05 [95% confidence interval {CI} 0.93-1.19]) or neonatal (aOR 1.13 [95% CI 0.87-1.46]) outcomes between rural and nonrural pregnancies. Among this sample of low-risk women who planned midwife-led community births, no increased risk was detected by rural vs nonrural status. © 2017 Wiley Periodicals, Inc.

  16. Development of Rural Communities by Diversification of Rural Economy in the Context of Sustainable Development

    Directory of Open Access Journals (Sweden)

    Manuela Dora Orboi

    2012-05-01

    Full Text Available The sustainable development is a process taking place at the same time with the complex and sustainable agricultural development; agriculture and the rural area being interdependent sides specific to rural communities. When analysing economic activity in the rural area we should pay a particular attention to the identification of such alternative activities that have a real chance for development and create new jobs that compensate the diminution of labour occupancy degree in agriculture. Opportunities of rural economy represent a source of having alternative income for the population from rural communities in order to escape from poverty and in order to accelerate the social progress in the rural area. Alternative activities with economic, social and cultural impact, providers of jobs and incomes are: the development of agro tourism and rural tourism, processing and promoting foodstuff, local traditional drinks, ecological foodstuff, handicraft and silviculture. Improving the conditions for business in the rural area is a main condition for the generation of economic activities generating jobs in the rural area.

  17. Tourism and rural community development in Namibia: policy issues review

    Directory of Open Access Journals (Sweden)

    Erling Kavita

    2016-02-01

    Full Text Available During the past decades, the tourism sector has become an increasing important issue for governments and regional agencies searching for socio-economic development. Especially in the Global South the increasing tourism demand has been seen highly beneficial as evolving tourism can create direct and indirect income and employment effects to the host regions and previously marginalised communities, with potential to aid with the poverty reduction targets. This research note reviews the existing policy and planning frameworks in relation to tourism and rural development in Namibia. Especially the policy aims towards rural community development are overviewed with focus on Community-Based Tourism (CBT initiatives. The research note involves a retrospective review of tourism policies and rural local development initiatives in Namibia where the Ministry of Environment and Tourism (MET initiated a community-based tourism policy. The policy emphasises structures and processes helping local communities to benefit from the tourism sector, and the active and coordinating involvement of communities, especially, is expected to ensure that the benefits of tourism trickle down to the local level where tourist activities take place. However, it is noted that in addition to public policy-makers also other tourism developers and private business environment in Namibia need to recognize the full potential of rural tourism development in order to meet the created politically driven promises at the policy level. In this respect, a national tourism policy could provide an enabling framework, integrating the tourism sector’s development aims to rural and community development needs in future. In addition, there is a need to coordinate a comprehensive vision of what type of rural tourism development or tourism in rural environments holds the most potential to benefit both local communities and the mainstream sector.

  18. Longitudinal course and predictors of suicidal ideation in a rural community sample.

    Science.gov (United States)

    Handley, Tonelle E; Attia, John R; Inder, Kerry J; Kay-Lambkin, Frances J; Barker, Daniel; Lewin, Terry J; Kelly, Brian J

    2013-11-01

    Suicide rates in rural Australia are higher than in urban areas. No existing research has explored the long-term patterns and predictors of change in suicidal ideation within rural areas. This report uses longitudinal data and multiple time points to determine predictors of the trajectory of suicidal ideation in rural Australia. Participants in the Australian Rural Mental Health Study (ARMHS) completed self-report surveys at baseline, 12 and 36 months, reporting their psychological and social well-being, and suicidal ideation. Generalised linear mixed models explored these factors as correlates and predictors of suicidal ideation across 3 years using multiple data points. A total of 2135 participants completed at least one wave of ARMHS, and hence were included in the current analysis. Overall, 8.1% reported suicidal ideation during at least one study wave, 76% of whom reported suicidal ideation intermittently rather than consistently across waves. Across the three time points, suicidal ideation was significantly associated with higher psychological distress (OR 1.30, 95% CI 1.23 to 1.37), neuroticism (OR 1.15, 95% CI 1.04 to 1.27), and availability of support (OR 0.80, 95% CI 0.69 to 0.92), with a non-significant association with unemployment (OR 1.73, 95% CI 0.93 to 3.24) even after controlling for the effects of perceived financial hardship. Future suicidal ideation was significantly predicted by distress (OR 1.16, 95% CI 1.09 to 1.23) and neuroticism (OR 1.17, 95% CI 1.03 to 1.32), with a non-significant association with unemployment (OR 2.11, 95% CI 0.41 to 2.27). Predictive effects for marital status, social networks, sense of community and availability of support did not remain significant in the full multivariate analysis. Fluctuations in suicidal ideation are common, and may be associated with changes in psychological and social well-being. Public health strategies, focusing on encouraging help-seeking among those with higher psychological distress, lower

  19. BIOGAS TECHNOLOGY INTRODUCTIONS AS RENEWABLE ENERGY FOR RURAL COMMUNITIES

    Directory of Open Access Journals (Sweden)

    Meita Rumbayan

    2017-03-01

    Full Text Available This paper is the progress report of research action about biogas technology introduction for a rural community in North Sulawesi, Indonesia. The purpose of this study is to discuss biogas technology utilization in the selected rural. The research method is done by literature review, interview, site visit, data collection using questioner and case study of pilot project development in biogas technology for a household in Kosio village indicate a positive response from the local community. The discussion based on literature review, data collection and case study gives some recommendations for further study in term of scenario and guideline for the development of biogas technology for rural communities.

  20. The rural community care gerontologic nurse entrepreneur: role development strategies.

    Science.gov (United States)

    Caffrey, Rosalie A

    2005-10-01

    Rural elderly individuals are an underserved population with limited access to health care. There is an increasing need for independent community care nurses to provide assistance to home-based elderly individuals with chronic illnesses to prevent unnecessary medical and placement decisions and, thus, allow them to maintain independence and quality of life. This article describes the rural setting and why community care nurses are needed, and explores strategies for implementing the role of the independent nurse entrepreneur in caring for community-based elderly individuals in rural settings.

  1. The rural pipeline to longer-term rural practice: General practitioners and specialists.

    Directory of Open Access Journals (Sweden)

    Marcella M S Kwan

    Full Text Available Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS. In particular, we wished to determine predictors of graduates' longer-term rural practice and whether the predictors differ between general practitioners (GPs and specialists.A cross-sectional cohort study, conducted in 2012, of 729 medical graduates of The University of Queensland 2002-2011. The outcome of interest was primary place of graduates' practice categorised as rural for at least 50% of time since graduation ('Longer-term Rural Practice', LTRP among GPs and medical specialists. The main exposures were rural background (RB or metropolitan background (MB, and attendance at a metropolitan clinical school (MCS or the Rural Clinical School for one year (RCS-1 or two years (RCS-2.Independent predictors of LTRP (odds ratio [95% confidence interval] were RB (2.10 [1.37-3.20], RCS-1 (2.85 [1.77-4.58], RCS-2 (5.38 [3.15-9.20], GP (3.40 [2.13-5.43], and bonded scholarship (2.11 [1.19-3.76]. Compared to being single, having a metropolitan background partner was a negative predictor (0.34 [0.21-0.57]. The effects of RB and RCS were additive-compared to MB and MCS (Reference group: RB and RCS-1 (6.58[3.32-13.04], RB and RCS-2 (10.36[4.89-21.93]. Although specialists were less likely than GPs to be in LTRP, the pattern of the effects of rural exposures was similar, although some significant differences in the effects of the duration of RCS attendance, bonded scholarships and partner's background were apparent.Among both specialists and GPs, rural background and rural clinical school attendance are independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan

  2. Community participation to design rural primary healthcare services.

    Science.gov (United States)

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  3. Contributors to suicidality in rural communities: beyond the effects of depression

    Science.gov (United States)

    2012-01-01

    Background Rural populations experience a higher suicide rate than urban areas despite their comparable prevalence of depression. This suggests the identification of additional contributors is necessary to improve our understanding of suicide risk in rural regions. Investigating the independent contribution of depression, and the impact of co-existing psychiatric disorders, to suicidal ideation and suicide attempts in a rural community sample may provide clarification of the role of depression in rural suicidality. Methods 618 participants in the Australian Rural Mental Health Study completed the Composite International Diagnostic Interview, providing assessment of lifetime suicidal ideation and attempts, affective disorders, anxiety disorders and substance-use disorders. Logistic regression analyses explored the independent contribution of depression and additional diagnoses to suicidality. A receiver operating characteristic (ROC) analysis was performed to illustrate the benefit of assessing secondary psychiatric diagnoses when determining suicide risk. Results Diagnostic criteria for lifetime depressive disorder were met by 28% (174) of the sample; 25% (154) had a history of suicidal ideation. Overall, 41% (63) of participants with lifetime suicidal ideation and 34% (16) of participants with a lifetime suicide attempt had no history of depression. When lifetime depression was controlled for, suicidal ideation was predicted by younger age, being currently unmarried, and lifetime anxiety or post-traumatic stress disorder. In addition to depression, suicide attempts were predicted by lifetime anxiety and drug use disorders, as well as younger age; being currently married and employed were significant protective factors. The presence of comorbid depression and PTSD significantly increased the odds of reporting a suicide attempt above either of these conditions independently. Conclusions While depression contributes significantly to suicidal ideation, and is a key

  4. Getting to know the island: Artistic experiments in rural community development

    OpenAIRE

    Crawshaw, Julie

    2016-01-01

    This paper makes an original contribution to our understandings of the relational role of artistic practice as part of rural community development. Art-led initiatives are now commonplace in rural development strategies. However, the effects of art in rural community, particularly beyond economic development, have received little attention. In this paper we seek to address this omission by exploring artistic ex- periments as part of community development processes. Theoretically, we draw on r...

  5. Constructions of Local Culture and Impacts on Domestic Violence in an Australian Rural Community

    Science.gov (United States)

    Wendt, Sarah

    2009-01-01

    Studies of domestic violence in rural areas have predominantly focused on barriers that keep women trapped in abusive relationships. The literature has frequently suggested that rural culture influences the incidence of domestic violence, the forms it takes, and how it is experienced. Yet there is surprisingly little research on how rural culture…

  6. Blind Spots: Small Rural Communities and High Turnover in the Superintendency

    Science.gov (United States)

    Kamrath, Barry; Brunner, C. Cryss

    2014-01-01

    This article examines high superintendency turnover through rural community members' perceptions of such attrition in their districts. Findings indicate that community members perceived high turnover as negative and believed that turnover was created by financial pressures, rural community resistance to educational trends, and bias against…

  7. Environmental resources and poverty in rural communities

    DEFF Research Database (Denmark)

    Charlery, Lindy Callen

    , is to be sustainably realized. However, most datasets on rural livelihoods do not accurately account for environmental income and therefore cannot answer this question. The Poverty Environment Network (PEN) project was initiated specifically to address this issue in the assessment of rural livelihoods in developing......D study focuses on answering two main research questions: 1) What is the importance of environmental income in assessments of poverty and poverty dynamics in rural forest reliant communities? and 2) What are the impacts of infrastructural development, in the form of rural roads, on rural household income......Over the last two decades, the burgeoning empirical evidence on the importance of forests and environmental resources to rural livelihoods in developing countries has attracted the attention of policy makers aiming to develop and implement strategies for reducing poverty and improving livelihoods...

  8. Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand

    Directory of Open Access Journals (Sweden)

    Lorga T

    2012-03-01

    Full Text Available Thaworn Lorga1, Myo Nyein Aung1,2, Prissana Naunboonruang1, Payom Thinuan1, Nara Praipaksin3, Tida Deesakul3, Utumporn Inwan3, Tawatchai Yingtaweesak4, Pratumpan Manokulanan1, Srisomporn Suangkaew1, Apiradee Payaprom41Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 2Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 3Baan Rekati Health Station, Thasongyang, Tak, Thailand; 4Thasongyang Hospital, Thasongyang, Tak, ThailandBackground: Diabetes is a growing epidemic in both urban and rural communities worldwide.Aim: We aimed to survey fasting plasma glucose (FPG status and awareness of diabetes in the rural Karen ethnic community. We investigated the predictors of impaired fasting plasma glucose (IFG status, which would be easily applicable for prevention of diabetes in a rural community.Materials and methods: This was a community-based cross-sectional study conducted at Thasongyang, the most north-western district in Thailand. A total of 299 Karen ethnic rural residents were included in the study. FPG, body mass index, and waist circumference were prospectively measured. We assessed the awareness of diabetes and lifestyle-related health behavior with closed questionnaires in a rural community setting.Results: On screening for FPG, 16.72% of the Karen ethnic residents had hyperglycemia: 3.68% in the diabetic range and 13.04% in the prediabetic range respectively. After adjustment for age, sex, and BMI, waist circumference (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.29–9.57, and having a diabetic blood relative (aOR 4.6, CI 1.81–11.71 are significant predictors of IFG status.Conclusion: It is necessary to promote awareness of diabetes among the Karen ethnic community. Application of simple evidence-based predictors of the prediabetic state may lead to timely and effective prevention of diabetes in rural settings.Keywords: diabetes, prediabetes, fasting plasma

  9. Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

    Science.gov (United States)

    Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

    2014-12-11

    Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.

  10. Integrated Water Resources Simulation Model for Rural Community

    Science.gov (United States)

    Li, Y.-H.; Liao, W.-T.; Tung, C.-P.

    2012-04-01

    The purpose of this study is to develop several water resources simulation models for residence houses, constructed wetlands and farms and then integrate these models for a rural community. Domestic and irrigation water uses are the major water demand in rural community. To build up a model estimating domestic water demand for residence houses, the average water use per person per day should be accounted first, including water uses of kitchen, bathroom, toilet and laundry. On the other hand, rice is the major crop in the study region, and its productive efficiency sometimes depends on the quantity of irrigation water. The water demand can be estimated by crop water use, field leakage and water distribution loss. Irrigation water comes from rainfall, water supply system and reclaimed water which treated by constructed wetland. In recent years, constructed wetlands play an important role in water resources recycle. They can purify domestic wastewater for water recycling and reuse. After treating from constructed wetlands, the reclaimed water can be reused in washing toilets, watering gardens and irrigating farms. Constructed wetland is one of highly economic benefits for treating wastewater through imitating the processing mechanism of natural wetlands. In general, the treatment efficiency of constructed wetlands is determined by evapotranspiration, inflow, and water temperature. This study uses system dynamics modeling to develop models for different water resource components in a rural community. Furthermore, these models are integrated into a whole system. The model not only is utilized to simulate how water moves through different components, including residence houses, constructed wetlands and farms, but also evaluates the efficiency of water use. By analyzing the flow of water, the water resource simulation model can optimizes water resource distribution under different scenarios, and the result can provide suggestions for designing water resource system of a

  11. LEADERSHIP IN RURAL CONGREGATIONS AND COMMUNITIES ...

    African Journals Online (AJOL)

    unemployment. Congregations in rural communities and their leadership cannot ..... for all leadership styles, definitions and preferences, namely leadership influences the ... Irrespective of whether a leader prefers an autocratic, bureaucratic ...

  12. The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents.

    Science.gov (United States)

    Bolton, Kristy A; Jacka, Felice; Allender, Steven; Kremer, Peter; Gibbs, Lisa; Waters, Elizabeth; de Silva, Andrea

    2016-10-01

    This study examines the relationship between diet quality and health-related quality of life (HRQoL) in rural and urban Australian adolescents, and gender differences. Cross-sectional. Secondary schools. 722 rural and 422 urban students from 19 secondary schools. Self-report dietary-related behaviours, demographic information, HRQoL (AQoL-6D) were collected. Healthy and unhealthy diet quality scores were calculated; multiple linear regression investigated associations between diet quality and HRQoL. Compared to urban students, rural students had higher HRQoL, higher healthy diet score, lower unhealthy diet score, consumed less soft drink and less frequently, less takeaway and a higher proportion consumed breakfast (P health problems. Such interventions should consider gender and locality. © 2016 National Rural Health Alliance Inc.

  13. Integration of Rural Community Pharmacies into a Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis

    Directory of Open Access Journals (Sweden)

    Nicholas E. Hagemeier

    2015-01-01

    Full Text Available Purpose: Practice-based research networks (PBRN seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1 evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2 explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3 explore pharmacy key informant interest in PBRN participation. Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions. Findings: A 47.8% response rate was obtained. Most key informants (88% were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%, improved relationships with providers in the community (75.9%, and professional development opportunities (69.0% were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63% and workflow disruptions (20% as the biggest barriers to PBRN participation. Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas.   Type: Original Research

  14. Dementia and rural nuclear medicine

    International Nuclear Information System (INIS)

    Cowell, S.F.; Davison, A.; Logan-Sinclair, P.; Sturt University, Dubbo, NSW; Greenough, R.

    2003-01-01

    Full text: The rapid increase in dementia is directly related to the growing number of aged people in developed countries, such as Australia. This increase heightens the need for accurate dementia diagnosis to ensure treatment resources are appropriately allocated. However, current diagnostic methods are unable to determine specific dementia types limiting the effectiveness of many care plans. The lack of specialist resources in rural Australian communities presents nuclear medicine with an opportunity to make a significant impact on the management of this disease. This investigation aimed to identify how SPECT perfusion imaging could maximise its role in the management of dementia in a rural New South Wales setting. The study reviewed all Technetium 99m HMPAO SPECT brain studies over a three-year period. This included a medical record audit, review of all diagnostic imaging reports and an analysis of referral patterns. The results of this study provide compelling evidence that, even in a rural setting, brain SPECT, in conjunction with neuropsychological testing, offers high accuracy in determining the presence and type of dementia. In addition, the study found more than 30% of referrers had no training in SPECT, emphasising the importance of ensuring that brain SPECT reports, in a rural setting, educate and specify to referrers the significance and exact disease type found in the study. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  15. A rural African American faith community's solutions to depression disparities.

    Science.gov (United States)

    Bryant, Keneshia; Haynes, Tiffany; Kim Yeary, Karen Hye-Cheon; Greer-Williams, Nancy; Hartwig, Mary

    2014-01-01

    The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. The primary data sources for this qualitative research study were focus groups. Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community. © 2013 Wiley Periodicals, Inc.

  16. A rural, community-based suicide awareness and intervention program.

    Science.gov (United States)

    Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

    2015-01-01

    Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

  17. Rural schools and democratic education. The opportunity for community participation

    Directory of Open Access Journals (Sweden)

    Antonio Bustos Jiménez

    2011-08-01

    Full Text Available In the paper the notions of participation and community empowerment in rural schools are analysed through reflection on experiences conducted in different countries. Reference is made to ducational models of participatory development which, from the viewpoint of excellence, result in increasing educational outcomes and higher rates of satisfaction among the targeted rural populations. Taking as point of departure agents which are considered potential generators of knowledge in rural areas, we examine the process of incorporating the wealth of the rural context. The difficulties that the community group usually faces for its legitimacy as a source of input in rural areas are also shown. Finally, we discuss how the teaching staff can positively contribute to their process of joining the school life.

  18. The Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages.

    Science.gov (United States)

    Hussain, Rafat; Maple, Myfanwy; Hunter, Sally V; Mapedzahama, Virginia; Reddy, Prasuna

    2015-01-01

    Rural Australians experience poorer health and poorer access to health care services than their urban counterparts, and there is a chronic shortage of health professionals in rural and remote Australia. Strategies designed to reduce this rural-urban divide include fly-in fly-out (FIFO) and drive-in drive-out (DIDO) services. The aim of this article is to examine the opportunities and challenges involved in these forms of service delivery. This article reviews recent literature relating to FIFO and DIDO healthcare services and discusses their benefits and potential disadvantages for rural Australia, and for health practitioners. FIFO and DIDO have short-term benefits for rural Australians seeking healthcare services in terms of increasing equity and accessibility to services and reducing the need to travel long distances for health care. However, significant disadvantages need to be considered in the longer term. There is a potential for burnout among health professionals who travel long distances and work long hours, often without adequate peer support or supervision, in order to deliver these services. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary healthcare system in small rural communities. Given the potential negative consequences for both health professionals and rural Australians, the authors caution against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary healthcare services in rural and remote communities.

  19. Ice and the outback: Patterns and prevalence of methamphetamine use in rural Australia.

    Science.gov (United States)

    Roche, Ann; McEntee, Alice

    2017-08-01

    This study investigated whether lifetime and recent methamphetamine use (including crystal methamphetamine) differed among city, regional and rural residents and whether particular subpopulations were more at-risk. Secondary analyses of the last three National Drug Strategy Household Surveys and corresponding Alcohol and Other Drug Treatment Services National Minimum Data Sets (AODTS NMDS). Australian general population. Australians who completed the 2007 (n = 22 519), 2010 (n = 25 786) and 2013 (n = 23 512) NDSHS (aged 14 + ); and treatment episodes where the principal drug of concern was recorded in the 2006/2007 (n = 139 808), 2009/2010 (n = 139 608) and 2012/2013 (n = 154 489) AODTS NMDS. To determine whether rural Australians were more likely to use methamphetamine than non-rural counterparts. Lifetime and recent methamphetamine and recent crystal methamphetamine use were significantly higher among rural than other Australians. Significantly more rural men and employed rural Australians used methamphetamine than their city, regional or Australian counterparts. Rural Australians aged 18-24 and 25-29 years were significantly more likely to have used methamphetamine in their lifetime than city or Australian residents. Rural Australians aged 18-24 years were significantly more likely to have recently used crystal methamphetamine. Interventions tailored to address the specific and unique circumstances of rural settings are required to reduce and prevent methamphetamine use, particularly crystal methamphetamine. Scope exists to focus prevention efforts on rural workplaces and primary care settings. Greater understanding of the higher prevalence of methamphetamine use in rural areas is required, plus implementation of comprehensive strategies and optimised treatment utilisation. © 2016 National Rural Health Alliance Inc.

  20. Safety and community: the maternity care needs of rural parturient women.

    Science.gov (United States)

    Kornelsen, Jude; Grzybowski, Stefan

    2005-06-01

    To investigate rural parturient women's experiences of obstetric care in the context of the social and economic realities of life in rural, remote, and small urban communities. Data collection for this exploratory qualitative study was carried out in 7 rural communities chosen to represent diversity of size, distance to hospital with Caesarean section capability and distance to secondary hospital, usual conditions for transport and access, and cultural and ethnic subpopulations. We interviewed 44 women who had given birth up to 24 months before the study began. When asked about their experiences of giving birth in rural communities, many participants spoke of unmet needs and their associated anxieties. Self-identified needs were largely congruent with the deficit categories of Maslow's hierarchy of needs, which recognizes the contingency and interdependence of physiological needs, the need for safety and security, the need for community and belonging, self-esteem needs, and the need for self-actualization. For many women, community was critical to meeting psychosocial needs, and women from communities that currently have (or have recently had) access to local maternity care said that being able to give birth in their own community or in a nearby community was necessary if their obstetric needs were to be met. Removing maternity care from a community creates significant psychosocial consequences that are imperfectly understood but that probably have physiological implications for women, babies, and families. Further research into rural women's maternity care that considers the loss of local maternity care from multiple perspectives is needed.

  1. The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms.

    Science.gov (United States)

    Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony; Allan, Julaine; Bliss, Donna; Doran, Christopher

    2013-05-01

    Cognitive-behavioural interventions that use familial and community reinforcers in an individual's environment are effective for reducing alcohol-related harms. Such interventions have considerable potential to reduce the disproportionately high burden of alcohol-related harm among Aboriginal Australians if they can be successfully tailored to their specific needs and circumstances. The overall aim of this paper is to describe the perceived acceptability of two cognitive-behavioural interventions, the Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT), to a sample of Aboriginal people. Descriptive survey was administered to 116 Aboriginal people recruited through an Aboriginal Community Controlled Health Service and a community-based drug and alcohol treatment agency in rural New South Wales, Australia. Participants perceived CRA and CRAFT to be highly acceptable for delivery in their local Aboriginal community. Women were more likely than men to perceive CRAFT as highly acceptable. Participants expressed a preference for counsellors to be someone they knew and trusted, and who has experience working in their local community. CRA was deemed most acceptable for delivery to individuals after alcohol withdrawal and CRAFT for people who want to help a relative/friend start alcohol treatment. There was a preference for five or more detailed sessions. Findings of this study suggest that CRA and CRAFT are likely to be acceptable for delivery to some rural Aboriginal Australians, and that there is potential to tailor these interventions to specific communities. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  2. Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

    Science.gov (United States)

    Van Gelderen, Stacey A; Krumwiede, Kelly A; Krumwiede, Norma K; Fenske, Candace

    2018-01-01

    To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

  3. The Effects of Activity and Aging on Rural Community Living and Consuming.

    Science.gov (United States)

    Miller, Nancy J.; Kim, Soyoung; Schofield-Tomschin, Sherry

    1998-01-01

    Discusses a study of the effects of social activity and aging on variables related to individual motivations, community membership, and consumer behavior of respondents (n=630) living in rural communities. Findings suggest an embeddedness of marketplace activity in the social networks of rural communities. (Author/JOW)

  4. Does forest certification enhance community engagement in Australian plantation management?

    NARCIS (Netherlands)

    Dare, Melanie (Lain); Vanclay, Frank; Schirmer, Jacki

    The rapid expansion of timber plantations across Australia has been contentious, with ongoing debate in rural communities about the social, economic and environmental impacts of plantations. The need for effective and ongoing community engagement (CE) has been highlighted by this ongoing contention

  5. Building a Future without Gender Violence: Rural Teachers and Youth in Rural Kwazulu-Natal, South Africa, Leading Community Dialogue

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2014-01-01

    This article advances the idea that rural youth and teachers are the key in leading community dialogue towards addressing gender-based violence (GBV) in their community through their film making. The youth voices on the realities of GBV in their school and community, in rural KwaZulu-Natal, South Africa, captured through the process of…

  6. Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey.

    Science.gov (United States)

    Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret

    2015-04-18

    Racial discrimination denies those from racial and ethnic minority backgrounds access to rights such as the ability to participate equally and freely in community and public life, equitable service provision and freedom from violence. Our study was designed to examine how people from racial and ethnic minority backgrounds in four Australian localities experience and respond to racial discrimination, as well as associated health impacts. Data were collected from 1,139 Australians regarding types of racial discrimination experienced, settings for these incidents, response mechanisms and psychological distress as measured by the Kessler 6 (K6) Psychological Distress Scale. Age, education, religion, gender, visibility and rurality were all significantly associated with differences in the frequency of experiencing racial discrimination. Experiencing racial discrimination was associated with worse mental health. Mental health impacts were not associated with the type of discriminatory experience, but experiencing racial discrimination in shops and in employment and government settings was associated with being above the threshold for high or very high psychological distress. One out of twelve response mechanisms was found to be associated with lower stress following a discriminatory incident. Study results indicate that poorer mental health was associated with the volume of discrimination experienced, rather than the type of experience. However, the impact of experiencing discrimination in some settings was shown to be particularly associated with high or very high psychological distress. Our findings suggest that interventions designed to prevent the occurrence of racism have more potential to increase mental health in racial and ethnic minority communities than interventions that work with individuals in response to experiencing racism.

  7. Mitigation Efforts in Rural Communities after Extreme Weather Events - New Insights for Stakeholders

    Directory of Open Access Journals (Sweden)

    Vesela Radovic

    2016-09-01

    Full Text Available Global climate changes are undoubtedly course of the increasing frequency of extreme whether events all over the world. Rural communities belong to the “group of victims” which is greatly jeopardized by consequences of the extreme weather events. Having in mind limited capacities for the preparedness, response and recovery after any kind of emergency it is clear that the rural community mostly needs external help. That is the point of this paper: to make new insights about this important issue, and to discuss: “how to provide adequate help in the rural communities and build adequate adaptive and response capacities”. In many countries agriculture and rural tourism are main economic activities in the rural area and its interruption could be the obstacle for implementation of sustainable development. Various stakeholders omit to be aware of this issue. Emergency agencies and many others have to make the comprehensive plan for rural communities (having in mind all its limitations. In the Republic of Serbia rural communities do not have enough capacity for recovery and usually it takes many years after an event. A minimum of an economic recovery standard has to be created for the rural community. It also has to be a specific contingency plan in the future reorganizations of emergency services in Serbia and at the Western Balkan region. It should be one of the priority issues for stakeholders in the near future in disaster risk reduction. Providing equal access to resources to population in the rural community after the extreme weather event has to be the priority task for policy makers and all actors in emergency management.

  8. Alaska Native Villages and Rural Communities Water Grant Program

    Science.gov (United States)

    Significant human health and water quality problems exist in Alaska Native Village and other rural communities in the state due to lack of sanitation. To address these issues, EPA created the Alaska Rural and Native Villages Grant Program.

  9. "Everybody Knows Everybody Else's Business"-Privacy in Rural Communities.

    Science.gov (United States)

    Leung, Janni; Smith, Annetta; Atherton, Iain; McLaughlin, Deirdre

    2016-12-01

    Patients have a right to privacy in a health care setting. This involves conversational discretion, security of medical records and physical privacy of remaining unnoticed or unidentified when using health care services other than by those who need to know or whom the patient wishes to know. However, the privacy of cancer patients who live in rural areas is more difficult to protect due to the characteristics of rural communities. The purpose of this article is to reflect on concerns relating to the lack of privacy experienced by cancer patients and health care professionals in the rural health care setting. In addition, this article suggests future research directions to provide much needed evidence for educating health care providers and guiding health care policies that can lead to better protection of privacy among cancer patients living in rural communities.

  10. The Components of Resilience--Perceptions of an Australian Rural Community

    Science.gov (United States)

    Buikstra, Elizabeth; Ross, Helen; King, Christine A.; Baker, Peter G.; Hegney, Desley; McLachlan, Kathryn; Rogers-Clark, Cath

    2010-01-01

    Resilience, of individuals, is a well-established concept in the psychology/mental health literatures, but has been little explored in relation to communities. Related theory in the community development and social impact assessment literature provides insight into qualities and assets of communities that enable them to develop effectively or to…

  11. Active living environment assessments in four rural Latino communities

    Directory of Open Access Journals (Sweden)

    Cynthia K. Perry

    2015-01-01

    Conclusions: These four rural towns have some policies, programming and infrastructure in place that support active living. The information from the RALA can be used to inform program and policy development to enhance physical activity in these rural communities.

  12. A Case Study of Rural Community Colleges' Transition to Entrepreneurship

    Science.gov (United States)

    Genandt, James D.

    2017-01-01

    The traditional role of workforce training by community colleges in support of regional economic development is insufficient to help rural areas survive in a global economy. Rural community colleges are uniquely positioned to provide enhanced economic development support through entrepreneurship and small business development programs. Using…

  13. Renewable energy for rural communities in Maharashtra, India

    International Nuclear Information System (INIS)

    Blenkinsopp, T.; Coles, S.R; Kirwan, K.

    2013-01-01

    The desire for universal access to modern energy and the use of renewable energy technologies (RETs) as a means of delivering low carbon solutions are driven by several local and global factors, including climate change, population increase and future energy security. Social attitudes are a major challenge to overcome in order to successfully introduce low carbon technologies as a sustainable alternative to more traditional means of energy provision. It becomes a challenge to educate the target population in order to counteract any negative preconceptions or scepticisms in using these technologies which can have adverse effect upon their viability and long term success. This work presents the results of a rural energy survey conducted in the Indian state of Maharashtra. The survey highlights the opportunities and attitudes of these rural communities towards sustainable modern energy services and the technologies used to deliver them. Results from the survey show that there is interest in using sustainable or renewable technologies for energy provision and suggest that cost, reliability and ease of use are more important factors than the environmental benefits. A suggestion for a way to improve RET adoption in rural communities is also presented based on the results of this study. - Highlights: • Survey used to assess energy usage and perception of RETs in rural communities. • Despite lack of preference towards one RET the majority believe in their expanded use. • Cost, reliability and ease of use most influential factors when selecting a fuel. • Assessment of community needs can aid RET adoption by improving long term viability

  14. Rural School In The Context Of Community-Led Local Development*

    Directory of Open Access Journals (Sweden)

    Hudečková H.

    2015-03-01

    Full Text Available The paper is based on the general concept of knowledge society and deals with regional development theories which emphasize local environment as an important part of rural development. The following two questions were studied: (1 What is the early experience of municipalities when establishing a Community School? (2 In which other municipalities would it be possible and appropriate to build such a school? For this purpose, both secondary and primary research methods were combined with data collection techniques – document study, observation, and questioning. Because the examined problem is set in the context of community-led local development (CLLD, violation of the ‘bottom-up’ approach principle is also highlighted. The paper presents the first experiences in the establishment of seven Community Schools within the Pilsen region and based on them also recommendations for the feasibility and suitability of establishing this type of school in other rural municipalities. The results show that the educational sector is not assisting in the modernization of rural schools with regard to community education and that the possibility of the contemporary and meaningful existence of schools in small rural municipalities remains ignored.

  15. Cost-Effective Strategies for Rural Community Outreach, Hawaii, 2010–2011

    Science.gov (United States)

    Barbato, Anna; Holuby, R. Scott; Ciarleglio, Anita E.; Taniguchi, Ronald

    2014-01-01

    Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members. PMID:25496555

  16. Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion

    Science.gov (United States)

    Flaherty, Mary Grace; Miller, David

    2016-01-01

    Rural residents are at a disadvantage with regard to health status and access to health promotion activities. In many rural communities, public libraries offer support through health information provision; there are also opportunities for engagement in broader community health efforts. In a collaborative effort between an academic researcher and a…

  17. Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature.

    Science.gov (United States)

    Hattingh, H Laetitia; Scahill, Shane; Fowler, Jane L; Wheeler, Amanda J

    2016-12-01

    Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.

  18. Rural and remote health research: Does the investment match the need?

    Science.gov (United States)

    Barclay, Lesley; Phillips, Andrew; Lyle, David

    2018-04-01

    To determine the percentage of research projects funded by the National Health and Medical Research Council in the period 2000-2014 that aimed specifically to deliver health benefits to Australians living in rural and remote areas and to estimate the proportion of total funding this represented in 2005-2014. This is a retrospective analysis of publicly available datasets. National Health and Medical Research Council Rural and Remote Health Research 2000-2014. 'Australian Rural Health Research' was defined as: research that focussed on rural or remote Australia; that related to the National Health and Medical Research Council's research categories other than Basic Science; and aimed specifically to improve the health of Australians living in rural and remote areas. Grants meeting the inclusion criteria were grouped according to the National Health and Medical Research Council's categories and potential benefit. Funding totals were aggregated and compared to the total funding and Indigenous funding for the period 2005-2014. Of the 16 651 National Health and Medical Research Council-funded projects, 185 (1.1%) that commenced funding during the period 2000-2014 were defined as 'Australian Rural Health Research'. The funding for Australian Rural Health Research increased from 1.0% of the total in 2005 to 2.4% in 2014. A summary of the funding according to the National Health and Medical Research Council's research categories and potential benefit is presented. Addressing the health inequality experienced by rural and remote Australians is a stated aim of the Australian Government. While National Health and Medical Research Council funding for rural health research has increased over the past decade, at 2.4% by value, it appears very low given the extent of the health status and health service deficits faced by the 30% who live in rural Australia. © 2018 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National

  19. The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

    Science.gov (United States)

    Radford, Kylie; Mack, Holly A; Robertson, Hamish; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Jackson Pulver, Lisa; Broe, Gerald A

    2014-06-01

    Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians. We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. "normal" range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of "gold standard" clinical consensus determinations of cognitive impairment and dementia. This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

  20. Community Readiness for the Promotion of Physical Activity in Older Adults—A Cross-Sectional Comparison of Rural and Urban Communities

    Science.gov (United States)

    Brand, Tilman; Princk, Christina; Zeeb, Hajo

    2018-01-01

    Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3–5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): −0.02–0.59). The rural communities showed significantly higher CR scores in the ‘Knowledge of efforts’ dimension (0.70, 95% CI: 0.26–1.14) and in the ‘Knowledge of the issue’ (0.37, 95% CI: 0.04–0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels. PMID:29509675

  1. Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

    Science.gov (United States)

    Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo

    2018-03-06

    Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

  2. Smart Growth Self-Assessment for Rural Communities

    Science.gov (United States)

    Tool to help small towns and rural communities assess their existing policies, plans, codes, and zoning regulations to determine how well they work to create healthy, environmentally resilient, and economically robust places.

  3. Identifying context-specific competencies required by community Australian Football sports trainers.

    Science.gov (United States)

    Donaldson, Alex; Finch, Caroline F

    2012-08-01

    First-aid is a recommended injury prevention and risk management strategy in community sport; however, little is known about the sport-specific competencies required by first-aid providers. To achieve expert consensus on the competencies required by community Australian Football (community-AF) sports trainers. A three-round online Delphi process. Community-AF. 16 Australian sports first-aid and community-AF experts. Rating of competencies as either 'essential', 'expected', 'ideal' or 'not required'. Results After Round 3, 47 of the 77 (61%) competencies were endorsed as 'essential' or 'expected' for a sports trainer to effectively perform the activities required to the standards expected at a community-AF club by ≥75% of experts. These competencies covered: the role of the sports trainer; the responsibilities of the sports trainer; emergency management; injury and illness assessment and immediate management; taping; and injury prevention and risk management. Four competencies (5%) were endorsed as 'ideal' or 'not required' by ≥85% of experts and were excluded from further consideration. The 26 competencies where consensus was not reached were retained as second-tier, optional competencies. Sports trainers are important members of on-field first-aid teams, providing support to both injured players and other sports medicine professionals. The competencies identified in this study provide the basis of a proposed two-tiered community-AF-specific sports trainer education structure that can be implemented by the peak sports body. This includes six mandatory modules, relating to the 'required' competencies, and a further six optional modules covering competencies on which consensus was not reached.

  4. Mobile phone usage in rural communities in Kwara state, Nigeria ...

    African Journals Online (AJOL)

    The rise in mobile telephony has continued to bridge the wide disparity between urban and rural dwellers, although there are suggestions that mobile phones have not been optimally utilized by rural dwellers. In view of this, the main aim of this study was to examine mobile phone usage in rural communities of Kwara State, ...

  5. Health concerns associated with unconventional gas mining in rural Australia.

    Science.gov (United States)

    Haswell, Melissa R; Bethmont, Anna

    2016-01-01

    Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning

  6. Exploration on Planning Methods for Rural Communities in the Local Economic and Institutional Contexts

    Institute of Scientific and Technical Information of China (English)

    Ying; WANG; Xin; PAN; Zhilun; XIAO; Xiangwei; CHENG; Caige; LI

    2014-01-01

    This paper reviews the wave of rural community construction, compares the urban and rural areas on the aspects of land property right, financing channels, construction management procedures, and the user-builder difference, and examines the unique characteristics of rural communities. On the basis of that, it proposes some planning methods for the rural community planning and construction, such as encouraging public participation, conducting public facility-oriented planning, and providing house-design menu, and further puts forward some supporting measures and policies.

  7. Leadership in rural congregations and communities: an exploration ...

    African Journals Online (AJOL)

    Congregations in rural communities and their leadership cannot escape these changes that affect their functioning and existence. The key research question is thus: What is the congregational leadership's opinion and argument about leadership in both the congregation and the community? The research indicated that a ...

  8. Rural Action: A Collection of Community Work Case Studies.

    Science.gov (United States)

    Henderson, Paul, Ed.; Francis, David, Ed.

    This book contains 10 case studies of rural community development in England, Wales, Scotland, Ireland, and Catalonia, as seen from the perspective of community-work practitioners. Development projects encompassed such activities as promotion of tourism, establishment of community centers, vocational training for school dropouts, adult community…

  9. Migration, Rural Poverty and Community Natural Resource ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Migration, Rural Poverty and Community Natural Resource Management in Cambodia. Cambodia has a ... Cambodia, Far East Asia, Central Asia, South Asia ... Call for new OWSD Fellowships for Early Career Women Scientists now open.

  10. Community-Based Rural Tourism: A Proposed Sustainability Framework

    Directory of Open Access Journals (Sweden)

    Kayat Kalsom

    2014-01-01

    Full Text Available Many tourism projects run by community in the rural areas are labelled as Community-based Rural Tourism (CBRT, a type of a more ‘responsible’ tourism that contributes to sustainable development. However, a framework is needed to enable planners and managers to understand its criteria thus ensuring that the CBRTs fulfil the sustainability requirement. This paper presents findings from a literature review on previous writings in this topic. Findings from an analysis on the criteria of a sustainable CBRT product are discussed. It is found that in order for it to play a role in sustainable development, a CBRT product must focus on competitive management, resource conservation, and benefit creation to the community. The three elements need to be supported, in turn, by community involvement and commitment. As the proposed conceptual framework of sustainable CBRT product can be a basis for further research in CBRT, it offers producing theoretical and practical implications.

  11. Training and experience of nurses in responding to alcohol misuse in rural communities.

    Science.gov (United States)

    Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine

    2013-07-01

    Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.

  12. The Role of Rural Communities in the Postsecondary Preparation of Low-Income Students

    Science.gov (United States)

    Alleman, Nathan F.; Holly, L. Neal

    2014-01-01

    In the past decade, rural education has been critiqued for contributing to brain drain and social stratification that saps the human, social, and economic resources of rural communities. This article, based on an investigation of six small rural school districts in the same state, offers an alternative view of the role of community groups and…

  13. Mental health literacy among refugee communities: differences between the Australian lay public and the Iraqi and Sudanese refugee communities.

    Science.gov (United States)

    May, Samantha; Rapee, Ronald M; Coello, Mariano; Momartin, Shakeh; Aroche, Jorge

    2014-05-01

    This study investigated differences in mental health knowledge and beliefs between participants from the Iraqi and Sudanese refugee communities, and Australian-born individuals, in Sydney, Australia. Ninety-seven participants were given vignettes of characters describing symptoms of major depressive disorder and posttraumatic stress. They were required to identify psychological symptoms as disorders, rate beliefs about the causes of and helpful treatments for these disorders, and rate attitude statements regarding the two characters. Australian participants recognized the presented symptoms as specific mental disorders significantly more than Iraqi and Sudanese participants did, and reported causal and treatment beliefs which were more congruent with expert beliefs as per the western medical model of mental disorder. The Sudanese group endorsed supernatural and religious causal beliefs regarding depression and posttraumatic stress symptoms most often; but both Sudanese and Iraqi participants strongly supported options from the supernatural and religious treatment items. However, evidence for pluralistic belief systems was also found. Although sampling was non-random, suggesting caution in the interpretation of results, it appears that the mental health literacy of lay Australians may be more aligned with the western medical model of mental disorder than that of Iraqi and Sudanese refugee communities. Mental health literacy support needs of Iraqi and Sudanese refugee communities resettled in western countries such as Australia might include education about specific symptoms and causes of mental disorder and the effectiveness of psychiatric treatments. These findings provide useful directions for the promotion of optimal service utilization among such communities.

  14. Farming fit? Dispelling the Australian agrarian myth

    Directory of Open Access Journals (Sweden)

    McCoombe Scott

    2011-03-01

    Full Text Available Abstract Background Rural Australians face a higher mental health and lifestyle disease burden (obesity, diabetes and cardiovascular disease than their urban counterparts. Our ongoing research reveals that the Australian farming community has even poorer physical and mental health outcomes than rural averages. In particular, farm men and women have high rates of overweightness, obesity, abdominal adiposity, high blood pressure and psychological distress when compared against Australian averages. Within our farming cohort we observed a significant association between psychological distress and obesity, abdominal adiposity and body fat percentage in the farming population. Presentation of hypothesis This paper presents a hypothesis based on preliminary data obtained from an ongoing study that could potentially explain the complex correlation between obesity, psychological distress and physical activity among a farming population. We posit that spasmodic physical activity, changing farm practices and climate variability induce prolonged stress in farmers. This increases systemic cortisol that, in turn, promotes abdominal adiposity and weight gain. Testing the hypothesis The hypothesis will be tested by anthropometric, biochemical and psychological analysis matched against systemic cortisol levels and the physical activity of the subjects. Implications of the hypothesis tested Previous studies indicate that farming populations have elevated rates of psychological distress and high rates of suicide. Australian farmers have recently experienced challenging climatic conditions including prolonged drought, floods and cyclones. Through our interactions and through the media it is not uncommon for farmers to describe the effect of this long-term stress with feelings of 'defeat'. By gaining a greater understanding of the role cortisol and physical activity have on mental and physical health we may positively impact the current rates of psychological

  15. Internet use in rural and remote Western Australia

    OpenAIRE

    Madden, Gary G; Coble-Neal, Grant

    2003-01-01

    Australian telecommunications universal service policy has recently been extended to include the provision of basic data services within a contestable universal service framework. In view of this fundamental policy change,infor mation about the demand for telecommunication services is critical if competition is to deliver intended outcomes. This analysis examines the demand for Internet in rural and remote communities in Western Australia. Toward this end econometric Internet subscription ...

  16. Community participation and mental health during retirement in community sample of Australians.

    Science.gov (United States)

    Olesen, Sarah C; Berry, Helen L

    2011-03-01

    This study considered whether community participation during later adulthood is more strongly associated with mental health during retirement than it is while in employment; i.e. in the absence of paid work. Participants were 322 men and 311 women aged 45 years and older, who were part of a random sample of an Australian coastal community. The frequency of participation across 14 types of community-based activities was assessed. Overall mental health was measured on a 10-item Kessler Psychological Distress Scale. Linear regression models tested the multivariate associations between distress and community participation, and whether this association differed for retired and working people. Retirees did not participate in their communities more than working people. The association between community participation and psychological distress did not differ by retirement status when people of all ages were considered together; however, stronger associations between several activities and (less) distress were found for retirees compared to their working peers in a younger cohort (aged 45 to 54). This cohort coincides with the average age of transition to retirement in Australia. These findings offer some support for the view that community participation may assist in managing the mental health implications of the transition from work to retirement.

  17. Income-generating projects in rural communities: from theory to ...

    African Journals Online (AJOL)

    Income-generating projects in rural communities: from theory to practice - a personal report. ISSN 0378-5254 Journal of Family Ecology and .... mine aspects of household resources management by women in one of the rural settlements ..... an administrative course presented by the support organisation to help them run the ...

  18. Provision of Information to Rural Communities in Bama Local ...

    African Journals Online (AJOL)

    Provision of Information to Rural Communities in Bama Local Government Area of Borno State, Nigeria. Y Aliyu, E Camble ... findings of the study showed that rural people in the Soye district have identifiable information needs mainly in the areas of agriculture, health, government programmes and small scale industries.

  19. Stakeholder views of rural community-based medical education: a narrative review of the international literature.

    Science.gov (United States)

    Somporn, Praphun; Ash, Julie; Walters, Lucie

    2018-03-30

    Rural community-based medical education (RCBME), in which medical student learning activities take place within a rural community, requires students, clinical teachers, patients, community members and representatives of health and government sectors to actively contribute to the educational process. Therefore, academics seeking to develop RCBME need to understand the rural context, and the views and needs of local stakeholders. The aim of this review is to examine stakeholder experiences of RCBME programmes internationally. This narrative literature review of original research articles published after 1970 utilises Worley's symbiosis model of medical education as an analysis framework. This model proposes that students experience RCBME through their intersection with multiple clinical, social and institutional relationships. This model seeks to provide a framework for considering the intersecting relationships in which RCBME programmes are situated. Thirty RCBME programmes are described in 52 articles, representing a wide range of rural clinical placements. One-year longitudinal integrated clerkships for penultimate-year students in Anglosphere countries were most common. Such RCBME enables students to engage in work-integrated learning in a feasible manner that is acceptable to many rural clinicians and patients. Academic results are not compromised, and a few papers demonstrate quality improvement for rural health services engaged in RCBME. These programmes have delivered some rural medical workforce outcomes to communities and governments. Medical students also provide social capital to rural communities. However, these programmes have significant financial cost and risk student social and educational isolation. Rural community-based medical education programmes are seen as academically acceptable and can facilitate symbiotic relationships among students, rural clinicians, patients and community stakeholders. These relationships can influence students' clinical

  20. Mental health academics in rural and remote Australia.

    Science.gov (United States)

    Pierce, David; Little, Fiona; Bennett-Levy, James; Isaacs, Anton N; Bridgman, Heather; Lutkin, Sarah J; Carey, Timothy A; Schlicht, Kate G; McCabe-Gusta, Zita P; Martin, Elizabeth; Martinez, Lee A

    2016-01-01

    The significant impact of mental ill health in rural and remote Australia has been well documented. Included among innovative approaches undertaken to address this issue has been the Mental Health Academic (MHA) project, established in 2007. Funded by the Australian Government (Department of Health), this project was established as a component of the University Departments of Rural Health (UDRH) program. All 11 UDRHs appointed an MHA. Although widely geographically dispersed, the MHAs have collaborated in various ways. The MHA project encompasses a range of activities addressing four key performance indicators. These activities, undertaken in rural and remote Australia, aimed to increase access to mental health services, promote awareness of mental health issues, support students undertaking mental health training and improve health professionals' capacity to recognise and address mental health issues. MHAs were strategically placed within the UDRHs across the country, ensuring an established academic base for the MHAs' work was available immediately. Close association with each local rural community was recognised as important. For most MHAs this was facilitated by having an established clinical role in their local community and actively engaging with the community in which they worked. In common with other rural health initiatives, some difficulties were experienced in the recruitment of suitable MHAs, especially in more remote locations. The genesis of this article was a national meeting of the MHAs in 2014, to identify and map the different types of activities MHAs had undertaken in their regions. These activities were analysed and categorised by the MHAs. These categories have been used as a guiding framework for this article. The challenge to increase community access to mental health services was addressed by (i) initiatives to address specific access barriers, (ii) supporting recruitment and retention of rural mental health staff, (iii) developing the

  1. Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

    Science.gov (United States)

    Dunstan, Debra; Anderson, Donnah

    2018-02-01

    The Personal Helpers and Mentors (PHaMs) service is a non-clinical, community-based Australian Government initiative aimed at increasing opportunities for recovery for people whose lives are severely affected by mental illness. Using a strengths-based recovery model, PHaMs caseworkers support and mentor people 'at risk of falling through the gaps' between state funded clinical treatment services and federally funded social services (such as supported housing, education and employment). While there is evidence that PHaMs realises its aim in metropolitan areas, little is known about how services are developed and function in low resource rural settings and what outcomes are achieved. These questions were addressed in a case study of a PHaMs service in a rural town in the state of New South Wales, Australia. Data were collected from two sources: local service documents prepared for staff orientation and operational purposes, and records and reports of service participants\\' performance and achievements. Participants\\' gains in wellbeing, recovery goals, and the target outcome areas of increased access to services, increased personal capacity and self-reliance, and increased community participation, were gathered from self-reports. The Role Functioning Scale was used as a measure of caseworker ratings of participants\\' adaptive functioning. The qualitative data were examined for semantic content and underlying themes. The quantitative analyses involved repeated measures and between-groups comparisons of uncontrolled pre-test–post-test and retrospective pre-test data. From commencement of the service in October 2009 to June 2014, an estimated 31% of the people living with severe mental illness in the local government area had accessed the PHaMs service (N=126; mean age 31.9 years; 42% male, 27% Aboriginal). The document analysis revealed that despite a lack of detail on how a PHaMs service should be developed or delivered, by focusing on the goal of client recovery

  2. A new inter-professional course preparing learners for life in rural communities.

    Science.gov (United States)

    Medves, Jennifer; Paterson, Margo; Chapman, Christine Y; Young, John H; Tata, Elizabeth; Bowes, Denise; Hobbs, Neil; McAndrews, Brian; O'Riordan, Anne

    2008-01-01

    The 'Professionals in Rural Practice' course was developed with the aim of preparing students enrolled in professional programs in Canada to become better equipped for the possible eventuality of professional work in a rural setting. To match the reality of living and working in a rural community, which by nature is interprofessional, the course designers were an interprofessional teaching team. In order to promote group cohesiveness the course included the participation of an interprofessional group of students and instructors from the disciplines of medicine, nursing, occupational therapy, physical therapy, teacher education, and theology. The format of the course included three-hour classes over an eight-week period and a two-day field experience in a rural community. The course utilized various experiential and interactive teaching and learning methods, along with a variety of assessment methods. Data were collected from student participants over two iterations of the course using a mixed methods approach. Results demonstrate that students value the interprofessional and experiential approach to learning and viewed this course as indispensable for gaining knowledge of other professions and preparation for rural practice. The data reveal important organizational and pedagogical considerations specific to interprofessional education, community based action research, and the unique interprofessional nature of training for life and work in a rural community. This study also indicates the potential value of further longitudinal study of participants in this course. Key words: Canada, community based action research, education, interdisciplinary, interprofessional.

  3. Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

    Science.gov (United States)

    Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

    2010-01-01

    Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…

  4. The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

    Science.gov (United States)

    Elder, W G; Amundson, B A

    1991-01-01

    The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

  5. Detecting the changes in rural communities in Taiwan by applying multiphase segmentation on FORMOSA-2 satellite imagery

    Science.gov (United States)

    Huang, Yishuo

    2015-09-01

    Agricultural activities mainly occur in rural areas; recently, ecological conservation and biological diversity are being emphasized in rural communities to promote sustainable development for rural communities, especially for rural communities in Taiwan. Therefore, since 2005, many rural communities in Taiwan have compiled their own development strategies in order to create their own unique characteristics to attract people to visit and stay in rural communities. By implementing these strategies, young people can stay in their own rural communities and the rural communities are rejuvenated. However, some rural communities introduce artificial construction into the community such that the ecological and biological environments are significantly degraded. The strategies need to be efficiently monitored because up to 67 rural communities have proposed rejuvenation projects. In 2015, up to 440 rural communities were estimated to be involved in rural community rejuvenations. How to monitor the changes occurring in those rural communities participating in rural community rejuvenation such that ecological conservation and ecological diversity can be satisfied is an important issue in rural community management. Remote sensing provides an efficient and rapid method to achieve this issue. Segmentation plays a fundamental role in human perception. In this respect, segmentation can be used as the process of transforming the collection of pixels of an image into a group of regions or objects with meaning. This paper proposed an algorithm based on the multiphase approach to segment the normalized difference vegetation index, NDVI, of the rural communities into several sub-regions, and to have the NDVI distribution in each sub-region be homogeneous. Those regions whose values of NDVI are close will be merged into the same class. In doing so, a complex NDVI map can be simplified into two groups: the high and low values of NDVI. The class with low NDVI values corresponds to those

  6. Making rural and remote communities more age-friendly: experts' perspectives on issues, challenges, and priorities.

    Science.gov (United States)

    Menec, Verena; Bell, Sheri; Novek, Sheila; Minnigaleeva, Gulnara A; Morales, Ernesto; Ouma, Titus; Parodi, Jose F; Winterton, Rachel

    2015-01-01

    With the growing interest worldwide in making communities more age-friendly, it is becoming increasingly important to understand the factors that help or hinder communities in attaining this goal. In this article, we focus on rural and remote communities and present perspectives of 42 experts in the areas of aging, rural and remote issues, and policy who participated in a consensus conference on age-friendly rural and remote communities. Discussions highlighted that strengths in rural and remote communities, such as easy access to local leaders and existing partnerships, can help to further age-friendly goals; however, addressing major challenges, such as lack of infrastructure and limited availability of social and health services, requires regional or national government buy-in and funding opportunities. Age-friendly work in rural and remote communities is, therefore, ideally embedded in larger age-friendly initiatives and supported by regional or national policies, programs, and funding sources.

  7. A cluster randomised trial to assess the impact of clinical pathways on AMI management in rural Australian emergency departments

    Directory of Open Access Journals (Sweden)

    Snow Pamela C

    2009-05-01

    Full Text Available Abstract Background People living in rural Australia are more likely to die in hospital following an acute myocardial infarction than those living in major cities. While several factors, including time taken to access hospital care, contribute to this risk, it is also partially attributable to the lower uptake of evidence-based guidelines for the administration of thrombolytic drugs in rural emergency departments where up to one-third of eligible patients do not receive this life-saving intervention. Clinical pathways have the potential to link evidence to practice by integrating guidelines into local systems, but their impact has been hampered by variable implementation strategies and sub-optimal research designs. The purpose of this study is to determine the impact of a five-step clinical pathways implementation process on the timely and efficient administration of thrombolytic drugs for acute myocardial infarctions managed in rural Australian emergency departments. Methods/Design The design is a two-arm, cluster-randomised trial with rural hospital emergency departments that treat and do not routinely transfer acute myocardial infarction patients. Six rural hospitals in the state of Victoria will participate, with three in the intervention group and three in the control group. Intervention hospitals will participate in a five-step clinical pathway implementation process: engagement of clinicians, pathway development according to local resources and systems, reminders, education, and audit and feedback. Hospitals in the control group will each receive a hard copy of Australian national guidelines for chest pain and acute myocardial infarction management. Each group will include 90 cases to give a power of 80% at 5% significance level for the two primary outcome measures: proportion of those eligible for thrombolysis receiving the drug and time to delivery of thrombolytic drug. Discussion Improved compliance with thrombolytic guidelines via

  8. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014-2015.

    Science.gov (United States)

    Lindblade, Kim A; Nyenswah, Tolbert; Keita, Sakoba; Diallo, Boubakar; Kateh, Francis; Amoah, Aurora; Nagbe, Thomas K; Raghunathan, Pratima; Neatherlin, John C; Kinzer, Mike; Pillai, Satish K; Attfield, Kathleen R; Hajjeh, Rana; Dweh, Emmanuel; Painter, John; Barradas, Danielle T; Williams, Seymour G; Blackley, David J; Kirking, Hannah L; Patel, Monita R; Dea, Monica; Massoudi, Mehran S; Barskey, Albert E; Zarecki, Shauna L Mettee; Fomba, Moses; Grube, Steven; Belcher, Lisa; Broyles, Laura N; Maxwell, T Nikki; Hagan, Jose E; Yeoman, Kristin; Westercamp, Matthew; Mott, Joshua; Mahoney, Frank; Slutsker, Laurence; DeCock, Kevin M; Marston, Barbara; Dahl, Benjamin

    2016-09-01

    Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.

  9. Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

    Directory of Open Access Journals (Sweden)

    Effiong Ekong Akpan

    2015-01-01

    Full Text Available Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978 participants were recruited from rural areas and five hundred and ninety (590 from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace (P<0.001, < 0.002, < 0.001, resp.. The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1–47.4% versus 28.6% (95% CI 24.9–32.3%]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria.

  10. Need for an Australian Indigenous disability workforce strategy: review of the literature.

    Science.gov (United States)

    Gilroy, John; Dew, Angela; Lincoln, Michelle; Hines, Monique

    2017-08-01

    To identify approaches for developing workforce capacity to deliver the National Disability Insurance Scheme (NDIS) to Indigenous people with disability in Australian rural and remote communities. A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors' knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis. Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce. An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers. Implications for Rehabilitation Indigenous people with disability living in rural and remote areas experience significant access and equity barriers to culturally appropriate supports and services that enable them to live independent, socially inclusive lives. A workforce strategy based on community-centered principles has potential for ensuring that the disability services sector meets the rehabilitation needs of Aboriginal people with disability living in rural and remote areas. Cultural training and

  11. Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-01-01

    Objectives To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Design Qualitative study with semistructured interviews and thematic analysis. Setting Four remote communities in outback Queensland, Australia. Participants 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. Results In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Conclusions Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. PMID:26515687

  12. Appropriate health promotion for Australian Aboriginal and Torres Strait Islander communities: crucial for closing the gap.

    Science.gov (United States)

    Demaio, Alessandro; Drysdale, Marlene; de Courten, Maximilian

    2012-06-01

    Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity building, community empowerment and local ownership. Culturally Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization and the Global Alliance for Health Promotion. It serves as a guide for community-focused health promotion practice to be built on and shaped by the respect for understanding and utilisation of local knowledge and culture. Culturally Appropriate Health Promotion is not about targeting, intervening or responding. Rather, it encourages health programme planners and policymakers to have a greater understanding, respect, a sense of empowerment and collaboration with communities, and their sociocultural environment to improve health. This commentary aims to examine and apply the eight principles of Culturally Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes a widespread adoption of the framework for a more respectful, collaborative, locally suitable and therefore appropriate approach to Australian Aboriginal and Torres Strait Islander health promotion.

  13. A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

    Science.gov (United States)

    Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

    2018-03-23

    The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

  14. Rural Colleges as Catalysts for Community Change: The RCCI Experience.

    Science.gov (United States)

    Rubin, Sarah

    2001-01-01

    The Rural Community College Initiative challenges colleges in economically distressed regions to become catalysts for economic and community development and improved access to education. Led by college-community teams, the 24 sites have experimented with strategic approaches that include leadership development, entrepreneurship education, small…

  15. Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

    Science.gov (United States)

    Godrich, Stephanie L; Lo, Johnny; Davies, Christina R; Darby, Jill; Devine, Amanda

    2017-01-03

    Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads ( n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria ( p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed ( p = 0.007), promotion ( p = 0.017), location of food outlets ( p = 0.027), and price ( p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

  16. Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

    Directory of Open Access Journals (Sweden)

    Stephanie L. Godrich

    2017-01-01

    Full Text Available Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD (i.e., food availability, access, and utilisation dimensions and adequate vegetable consumption among children living in regional and remote Western Australia (WA. Caregiver-child dyads (n = 256 living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23. A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20 for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007, promotion (p = 0.017, location of food outlets (p = 0.027, and price (p = 0.043. Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

  17. Technological Education for the Rural Community (TERC) Project: Technical Mathematics for the Advanced Manufacturing Technician

    Science.gov (United States)

    McCormack, Sherry L.; Zieman, Stuart

    2017-01-01

    Hopkinsville Community College's Technological Education for the Rural Community (TERC) project is funded through the National Science Foundation Advanced Technological Education (NSF ATE) division. It is advancing innovative educational pathways for technological education promoted at the community college level serving rural communities to fill…

  18. Project GRACE: a staged approach to development of a community-academic partnership to address HIV in rural African American communities.

    Science.gov (United States)

    Corbie-Smith, Giselle; Adimora, Adaora A; Youmans, Selena; Muhammad, Melvin; Blumenthal, Connie; Ellison, Arlinda; Akers, Aletha; Council, Barbara; Thigpen, Yolanda; Wynn, Mysha; Lloyd, Stacey W

    2011-03-01

    The HIV epidemic is a health crisis in rural African American communities in the Southeast United States; however, to date little attention has been paid to community-academic collaborations to address HIV in these communities. Interventions that use a community-based participatory research (CBPR) approach to address individual, social, and physical environmental factors have great potential for improving community health. Project GRACE (Growing, Reaching, Advocating for Change and Empowerment) uses a CBPR approach to develop culturally sensitive, feasible, and sustainable interventions to prevent the spread of HIV in rural African American communities. This article describes a staged approach to community-academic partnership: initial mobilization, establishment of organizational structure, capacity building for action, and planning for action. Strategies for engaging rural community members at each stage are discussed; challenges faced and lessons learned are also described. Careful attention to partnership development has resulted in a collaborative approach that has mutually benefited both the academic and community partners.

  19. Premises of Sustainable Development on Rural Communities

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    Anca Turtureanu

    2011-05-01

    Full Text Available In this paper the authors want to highlight the opportunity on rural areas and development in termsof durability. The content of sustainable development offers to local communities real and lasting solutions.In this sense for a community to be truly sustainable, it must adopt a holistic approach, taking into accountshort-term environmental and economic sustainability of natural and cultural resources. The authors believethat a sustainable community among its objectives to include their major environmental issues, povertyeradication, improvement of quality of life, developing and maintaining an effective and viable localeconomies, leading to a global vision of sustainable development of all sectors of the community.

  20. Engaging rural women in healthy lifestyle programs: insights from a randomized controlled trial.

    Science.gov (United States)

    Kozica, Samantha L; Harrison, Cheryce L; Teede, Helena J; Ng, Sze; Moran, Lisa J; Lombard, Catherine B

    2015-09-16

    The obesity epidemic is well established, particularly in rural settings. Programs promoting healthy lifestyles for rural women are urgently needed; however, participant engagement is challenging. In the context of a large randomized controlled trial targeting the prevention of weight gain in rural women, we explored successful recruitment strategies and aimed to understand participants' barriers, enablers and reasons for program participation. We recruited women (aged 18-55 years) from the general rural Australian population. A mixed-methods approach was applied to explore factors that influenced program participation, including quantitative questionnaires for all participants (n = 649) and qualitative semi-structured interviews conducted for a subgroup of participants (n = 45). Data were collected at three time points: baseline, 6 and 12 months post program commencement. We recruited 649 rural women through a community communication and partnering strategy, a program marketing campaign and mobilization of social networks. Program participants were diverse across education and income levels and were representative of the wider Australian regional population. Factors that influenced program engagement were divided into personal (perceived program benefits and program accessibility) and social (peer persuasion and support). Identified enablers included convenience of the program location, perceived program utility, such as weight management and optimization of lifestyle choices, as well as attending the program with peer support. Barriers to engagement, which are likely exacerbated in rural communities included lack of anonymity, self-consciousness and segregated social networks in rural settings. Participants reported that eliciting local support and maximizing publicity is fundamental to improving future program engagement. Multiple program promotion strategies including communication, marketing and partnering, as well as mobilization of social networks and peer

  1. Gender, Class and Rurality: Australian Case Studies

    Science.gov (United States)

    Bryant, Lia; Pini, Barbara

    2009-01-01

    The interrelationship between gender and class in rural spaces has received little attention. While rural scholars have focused on the implications for class from processes of gentrification and agricultural and rural restructuring, these analyses have remained largely ungendered. Similarly, feminist rural studies have rarely explored subjectivity…

  2. Ciclovia in a Rural Latino Community: Results and Lessons Learned.

    Science.gov (United States)

    Perry, Cynthia K; Ko, Linda K; Hernandez, Lidia; Ortiz, Rosa; Linde, Sandra

    Ciclovias involve the temporary closure of roads to motorized vehicles, allowing for use by bicyclists, walkers, and runners and for other physical activity. Ciclovias have been held in urban and suburban communities in the United States and Latin America. We evaluated the first ciclovia held in a rural, predominantly Latino community in Washington State. Three blocks within a downtown area in a rural community were closed for 5 hours on a Saturday in July 2015. The evaluation included observation counts and participant intercept surveys. On average, 200 participants were present each hour. Fourteen percent of youth (younger than 18 years) were observed riding bikes. No adults were observed riding bikes. A total of 38 surveys were completed. Respondents reported spending on average 2 hours at the ciclovia. Seventy-nine percent reported that they would have been indoors at home involved in sedentary activities (such as watching TV, working on computer) if they had not been at the ciclovia. Regularly held ciclovias, which are free and open to anyone, could play an important role in creating safe, accessible, and affordable places for physical activity in rural areas. Broad community input is important for the success of a ciclovia.

  3. Patient safety problem identification and solution sharing among rural community pharmacists.

    Science.gov (United States)

    Galt, Kimberly A; Fuji, Kevin T; Faber, Jennifer

    2013-01-01

    To implement a communication network for safety problem identification and solution sharing among rural community pharmacists and to report participating pharmacists' perceived value and impact of the network on patient safety after 1 year of implementation. Action research study. Rural community pharmacies in Nebraska from January 2010 to April 2011. Rural community pharmacists who voluntarily agreed to join the Pharmacists for Patient Safety Network in Nebraska. Pharmacists reported errors, near misses, and safety concerns through Web-based event reporting. A rapid feedback process was used to provide patient safety solutions to consider implementing across the network. Qualitative interviews were conducted 1 year after program implementation with participating pharmacists to assess use of the reporting system, value of the disseminated safety solutions, and perceived impact on patient safety in pharmacies. 30 of 38 pharmacists participating in the project completed the interviews. The communication network improved pharmacist awareness, promoted open discussion and knowledge sharing, contributed to practice vigilance, and led to incorporation of proactive safety prevention practices. Despite low participation in error and near-miss reporting, a dynamic communication network designed to rapidly disseminate evidence-based patient safety strategies to reduce risk was valued and effective at improving patient safety practices in rural community pharmacies.

  4. Community-Engaged Attribute Mapping: Exploring Resources and Readiness to Change the Rural Context for Obesity Prevention.

    Science.gov (United States)

    John, Deborah; Winfield, Tammy; Etuk, Lena; Hystad, Perry; Langellotto, Gail; Manore, Melinda; Gunter, Kathy

    2017-01-01

    Individual risk factors for obesity are well-known, but environmental characteristics that influence individual risk, especially in rural communities, are not confirmed. Rural communities face unique challenges to implementing environmental strategies, such as walkability, aimed at supporting weight healthy lifestyles. Cooperative Extension, a community-embedded weight health partner, convened and engaged community members in self-exploration of local resources and readiness to change environmental characteristics perceived to promote unhealthy eating and inactivity. This approach leveraged Extension's mission, which includes connecting rural communities with land-grant university resources. HEAL MAPPS™ (Healthy Eating Active Living Mapping Attributes using Participatory Photographic Surveys) was developed as a participatory action research methodology. Adopted by Extension community partners, HEAL MAPPS™ involved residents in photomapping, characterizing, and communicating lived experiences of their rural community, and prioritizing interventions to change the obesogenic context. Extension educators serving rural communities in six Western U.S. states were trained to implement HEAL MAPPS™. Extension engaged community members who mapped and evaluated their encounters with environmental attributes that shape their dietary and activity patterns. The method partnered residents with decision makers in identifying issues, assessing resources and readiness, and prioritizing locally relevant environmental strategies to reduce access disparities for rural populations with high obesity risk. HEAL MAPPS™ revealed differences in resource availability, accessibility, and affordability within and among rural communities, as well as in readiness to address the obesogenic context. Extension functioned successfully as the backbone organization, and local community health partner, cooperatively implementing HEAL MAPPS™ and engaging constituents in shaping weight healthy

  5. Non-dental primary care providers' views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study.

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-10-29

    To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Qualitative study with semistructured interviews and thematic analysis. Four remote communities in outback Queensland, Australia. 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Differences in health care seeking behaviour between rural and urban communities in South Africa

    Science.gov (United States)

    2012-01-01

    Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443

  7. The influence of rural clinical school experiences on medical students' levels of interest in rural careers.

    Science.gov (United States)

    Isaac, Vivian; Watts, Lisa; Forster, Lesley; McLachlan, Craig S

    2014-08-28

    Australian Rural Clinical School (RCS) programmes have been designed to create experiences that positively influence graduates to choose rural medical careers. Rural career intent is a categorical evaluation measure and has been used to assess the Australian RCS model. Predictors for rural medical career intent have been associated with extrinsic values such as students with a rural background. Intrinsic values such as personal interest have not been assessed with respect to rural career intent. In psychology, a predictor of the motivation or emotion for a specific career or career location is the level of interest. Our primary aims are to model over one year of Australian RCS training, change in self-reported interest for future rural career intent. Secondary aims are to model student factors associated with rural career intent while attending an RCS. The study participants were medical students enrolled in a RCS in the year 2013 at the University of New South Wales (UNSW) and who completed the newly developed self-administered UNSW Undergraduate Destinations Study (UDS) questionnaire. Data were collected at baseline and after one year of RCS training on preferred location for internship, work and intended specialty. Interest for graduate practice location (career intent) was assessed on a five-variable Likert scale at both baseline and at follow-up. A total of 165 students completed the UDS at baseline and 150 students after 1 year of follow-up. Factors associated with intent to practise in a rural location were rural background (χ2 = 28.4, P influence practice intent (toward rural practice) and interest levels (toward greater interest in rural practice).

  8. The Rural Open Air Museums: Visitors, Community and Place

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    Pawlikowska-Piechotka Anna

    2015-12-01

    Full Text Available Contemporary rural museums perform not only the traditional tasks but are also the places where both the visitors and the local community members have chances for entertainment and attractive leisure time. Consequently one can find in museums numerous catering offers such as cafes, bistros, snack bars, restaurants, pubs and wine bars. The material presented is the result of theoretical and field studies carried out in the selected open air museums in Poland and focused on newly introduced commercial activities (as catering. Our research results show that the development of sustainable cultural tourism as a generator of income in the open air rural museums is important in the challenging economic time. Museums having catering services of different character could easier overcome financial struggle. Moreover there is no doubt that the introduction of an interesting and ambitious cuisine in the restaurants located in the rural open air museum is of great importance also in other terms: popularization of the food culture, rural tradition of region, healthy diet and lifestyle, chance to increase the museum attractiveness, important economic support to the museum and the local community and the improvement of living quality.

  9. Cultural competence in working with the Arab Australian community: a conceptual review and the experience of the Arab Council Australia (ACA gambling help counselling service

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    Randa Mazbouh-Moussa

    2017-12-01

    Full Text Available Abstract Although Culturally And Linguistically Diverse (CALD communities participate less in gambling than the general population, those who gamble are more likely to show signs of disordered gambling (Moore and Ohtsuka International Gambling Studies, 1, 87–101, 2001; Raylu and Oei Clinical Psychology Review, 23, 1087–1114, 2004; Yamine and Thomas The impact of gaming on specific cultural groups, Victorian Casino and Gaming Authority, Melbourne, 2000. Research data on gambling problems and interventions in the Arab Australian community are extremely scarce. Therefore, this article will present an overview of the Arab Australian community and cultural issues regarding gambling within the Arab Australian community. Identifying these issues is important to work effectively with Arab Australians clients and those from other CALD backgrounds. The article also presents a conceptual review of peer-reviewed research articles on cultural competence in working with the Arab clients, the overview of Arab migration history to Australia and a summary of recent events that suggest a tension between Arab and non-Arab Australian communities. Observations and experiences that were encountered during the gambling counselling service operating in the Australian Arab community in New South Wales are also discussed. The research data to validate the effectiveness and positive impact of cultural competence are still in its early stages. However, a small number of community education resources have been available for working with the Arab community. From the data in annual reviews on the Arab Council Australia gambling counselling service, it was identified that cultural beliefs and expectations influence risk-taking decisions, identification of gambling issues, and preference of help seeking within the client’s social network. Further, culturally-specific sensitive issues related to political and global security events, which in turn influenced openness and

  10. Association between community garden participation and fruit and vegetable consumption in rural Missouri.

    Science.gov (United States)

    Barnidge, Ellen K; Hipp, Pamela R; Estlund, Amy; Duggan, Kathleen; Barnhart, Kathryn J; Brownson, Ross C

    2013-11-19

    Fruit and vegetable consumption reduces chronic disease risk, yet the majority of Americans consume fewer than recommended. Inadequate access to fruits and vegetables is increasingly recognized as a significant contributor to low consumption of healthy foods. Emerging evidence shows the effectiveness of community gardens in increasing access to, and consumption of, fruits and vegetables. Two complementary studies explored the association of community garden participation and fruit and vegetable consumption in rural communities in Missouri. The first was with a convenience sample of participants in a rural community garden intervention who completed self-administered surveys. The second was a population-based survey conducted with a random sample of 1,000 residents in the intervention catchment area. Participation in a community garden was associated with higher fruit and vegetable consumption. The first study found that individuals who worked in a community garden at least once a week were more likely to report eating fruits and vegetables because of their community garden work (X² (125) = 7.78, p = .0088). Population-based survey results show that 5% of rural residents reported participating in a community garden. Those who reported community garden participation were more likely to report eating fruits 2 or more times per day and vegetables 3 or more times per day than those who did not report community garden participation, even after adjusting for covariates (Odds Ratio [OR] = 2.76, 95% Confidence Interval [CI] = 1.35 to 5.65). These complementary studies provide evidence that community gardens are a promising strategy for promoting fruit and vegetable consumption in rural communities.

  11. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China.

    Science.gov (United States)

    Li, Man; Zhong, Renyao; Zhu, Shanwen; Ramsay, Lauren C; Li, Fen; Coyte, Peter C

    2018-06-06

    Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  12. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China

    Directory of Open Access Journals (Sweden)

    Man Li

    2018-06-01

    Full Text Available Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1 explore regional differences in community living infrastructure; and (2 to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  13. Virtual Rural Community Development: Human Links That Sustain Web Links.

    Science.gov (United States)

    Bright, Larry K.; Evans, Wayne H.; Marmet, Kathy

    Outmigration in the rural Upper Midwest prompted a group of citizens and University of South Dakota faculty to form the Center for the Advancement of Rural Communities (ARC). ARC considers how to stimulate traditionally competitive and isolated South Dakota peoples to collaborate for economic, social, educational, political, and cultural gains. As…

  14. Cancer outcomes for Aboriginal and Torres Strait Islander Australians in rural and remote areas.

    Science.gov (United States)

    Diaz, Abbey; Whop, Lisa J; Valery, Patricia C; Moore, Suzanne P; Cunningham, Joan; Garvey, Gail; Condon, John R

    2015-02-01

    To examine the association between residential remoteness and stage of cancer at diagnosis, treatment uptake, and survival within the Australian Indigenous population. Systematic review and matched retrospective cohort study. Australia. Systematic review: published papers that included a comparison of cancer stage at diagnosis, treatment uptake, mortality and/or survival for Indigenous people across remoteness categories were identified (n = 181). Fifteen papers (13 studies) were included in the review. Original analyses: new analyses were conducted using data from the Queensland Indigenous Cancer Study (QICS) comparing cancer stage at diagnosis, treatment uptake, and survival for Indigenous cancer patients living in rural/remote areas (n = 627, 66%) and urban areas (n = 329, 34%). Systematic review: Papers were included if there were related to stage of disease at diagnosis, treatment, mortality and survival of cancer. Restrictions were not placed on the outcome measures reported (e.g. standardised mortality ratios versus crude mortality rates). Original analyses: Odds ratios (OR, 95%CI) were used to compare stage of disease and treatment uptake between the two remoteness groups. Treatment uptake (treated/not treated) was analysed using logistic regression analysis. Survival was analysed using Cox proportional hazards regression. The final multivariate models included stage of cancer at diagnosis and area-level socioeconomic status (SEIFA). Existing evidence of variation in cancer outcomes for Indigenous people in remote compared with metropolitan areas is limited. While no previous studies have reported on differences in cancer stage and treatment uptake by remoteness within the Indigenous population, the available evidence suggests Indigenous cancer patients are less likely to survive their cancer the further they live from urban centres. New analysis of QICS data indicates that Indigenous cancer patients in rural/remote Queensland were less likely to be

  15. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities.

    Science.gov (United States)

    Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C; Thompson, R C Andrew

    2017-06-01

    Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively). The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7%) and soil (55.6%) in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to "closing the gap" in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  16. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities

    Directory of Open Access Journals (Sweden)

    Felicity A. Smout

    2017-06-01

    Full Text Available Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively. The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7% and soil (55.6% in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to “closing the gap” in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  17. Community members' views on Addis Ababa University's rural ...

    African Journals Online (AJOL)

    ... University's rural community health training program: A qualitative study. ... A total of five FGDs and six key informant interviews were conducted using a ... The audio-taped data was later transcribed verbatim and translated into English.

  18. Development of the good food planning tool: A food system approach to food security in indigenous Australian remote communities.

    Science.gov (United States)

    Brimblecombe, Julie; van den Boogaard, Christel; Wood, Beverley; Liberato, Selma C; Brown, Jacqui; Barnes, Adam; Rogers, Alison; Coveney, John; Ritchie, Jan; Bailie, Ross

    2015-07-01

    Few frameworks exist to assist food system planning, especially for Indigenous Australian remote communities. We developed a Good Food Planning Tool to support stakeholders to collectively plan and take action for local food system improvement. Development occurred over a four-year period through an evolving four phase participatory process that included literature review, several meetings with representatives of various organisations and communities and application of the Tool with multi-sector groups in each of four Indigenous Australian remote communities. A diverse range of 148 stakeholders, 78 of whom were Indigenous, had input to its development. Five food system domains: (i) Leadership and partnerships; (ii) Traditional food and local food production; (iii) Food businesses; (iv) Buildings, public places and transport; (v) Community and services and 28 activity areas form the framework of the Tool. The Good Food Planning Tool provides a useful framework to facilitate collective appraisal of the food system and to identify opportunities for food system improvement in Indigenous Australian remote communities, with potential for adaptation for wider application. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Barriers to Quality Care for Dying Patients in Rural Communities

    Science.gov (United States)

    Van Vorst, Rebecca F.; Crane, Lori A.; Barton, Phoebe Lindsey; Kutner, Jean S.; Kallail, K. James; Westfall, John M.

    2006-01-01

    Context: Barriers to providing optimal palliative care in rural communities are not well understood. Purpose: To identify health care personnel's perceptions of the care provided to dying patients in rural Kansas and Colorado and to identify barriers to providing optimal care. Methods: An anonymous self-administered survey was sent to health care…

  20. Self-help initiatives and rural development in Ibesikpo community of ...

    African Journals Online (AJOL)

    This study investigates the impact of self-help initiatives on rural development in Ibesikpo community of Akwa Ibom State, Nigeria. Self help initiatives were defined in terms of provision of employment, education and health-care. A sample size of 369 rural dwellers was drawn and data were analyzed using simple regression ...

  1. The role of cooperatives in sustaining the livelihoods of rural communities: The case of rural cooperatives in Shurugwi District, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Smart Mhembwe

    2017-04-01

    Full Text Available The main focus of the research was to analyse the role of cooperatives in sustaining the livelihoods of local rural communities in Shurugwi District in Zimbabwe. Descriptive survey design was used in this mixed method approach to the study. A questionnaire, interviews and observation methods were employed as the main research instruments. Purposive sampling technique was adopted and data were collected from government officials and from members of the six cooperatives in Shurugwi District. A total of 50 research participants were involved in the study. It was found that cooperatives were established as a strategy to sustain livelihoods of rural communities. With the adoption of cooperatives, people in the rural communities managed to generate employment, boost food production, empower the marginalised, especially women, and promote social cohesion and integration, thereby improving their livelihoods and reducing poverty. Most cooperatives face a number of challenges that include lack of financial support, poor management and lack of management skills, and lack of competitive markets to sell their produce. The study recommends that the government and the banking sector render financial support to cooperatives in rural communities to allow them to expand and diversify their business operations; constant training on leadership and management skills is provided to cooperatives’ members. There is also a need for cooperatives, especially those in the agricultural sector, to form some producer associations so as to easily market their produce. Lastly, the study recommends that future research should focus on investigating issues that hinder the growth of the cooperative movement in rural communities of Zimbabwe. It is hoped that policy-makers, the academia and communities would benefit from the study.

  2. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015

    Science.gov (United States)

    Nyenswah, Tolbert; Keita, Sakoba; Diallo, Boubakar; Kateh, Francis; Amoah, Aurora; Nagbe, Thomas K.; Raghunathan, Pratima; Neatherlin, John C.; Kinzer, Mike; Pillai, Satish K.; Attfield, Kathleen R.; Hajjeh, Rana; Dweh, Emmanuel; Painter, John; Barradas, Danielle T.; Williams, Seymour G.; Blackley, David J.; Kirking, Hannah L.; Patel, Monita R.; Dea, Monica; Massoudi, Mehran S.; Barskey, Albert E.; Zarecki, Shauna L. Mettee; Fomba, Moses; Grube, Steven; Belcher, Lisa; Broyles, Laura N.; Maxwell, T. Nikki; Hagan, Jose E.; Yeoman, Kristin; Westercamp, Matthew; Mott, Joshua; Mahoney, Frank; Slutsker, Laurence; DeCock, Kevin M.; Marston, Barbara; Dahl, Benjamin

    2016-01-01

    Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities. PMID:27268508

  3. Prevalence and socio-economic distribution of eating, physical activity and sedentary behaviour among South Australian children in urban and rural communities: baseline findings from the OPAL evaluation.

    Science.gov (United States)

    Bell, L; Ullah, S; Olds, T; Magarey, A; Leslie, E; Jones, M; Miller, M; Cobiac, L

    2016-11-01

    To identify current prevalence and sociodemographic distribution of adherence to national diet and physical activity and sedentary behaviour guidelines among Australian primary school children. Cross-sectional survey of children (n = 4637, 9-11 years) participating at baseline in the South Australian Obesity Prevention and Lifestyle (OPAL) programme evaluation. Self-reported diet, physical activity (PA) and screen time (ST) behaviours were assessed via questionnaire. Children were classified as meeting or not meeting each guideline (two or more serves of fruit, five or more serves of vegetables, two or less serves of discretionary food, ≥60 min of PA, and ≤2 h of ST per day). Although 65% of children met fruit recommendations, only 22% met vegetable recommendations (17% consumed no vegetables). Approximately one-quarter (28%) of children met discretionary food recommendations. Only 17% of children met the ST recommendations and 33% met PA recommendations. Less than 1% of children met all five recommendations. Rural children were more likely to meet both PA (OR = 1.45, 95% CI: 1.21-1.74, P < 0.001) and ST (OR = 1.37, 95% CI: 1.14-1.66, P < 0.01) recommendations than urban counterparts. Children at least socio-economic disadvantage performed better than those at greatest disadvantage for most behaviours. Improvement in Australian children's diet and physical activity and sedentary behaviours, particularly urban children and those at greatest socio-economic disadvantage, is urgently warranted. Copyright © 2016 The Royal Society for Public Health. All rights reserved.

  4. Community participation in rural Ecuador’s school feeding programme

    DEFF Research Database (Denmark)

    Torres, Irene; Simovska, Venka

    2017-01-01

    participation can include the possibility of the community challenging the social order at school, and the educational policies and practices. When addressing community participation, counter-participating and non-participating can be also considered as legitimate forms of participating. Originality/value......Purpose - The aim of this paper is to contribute to the debate concerning health education and health promotion at schools, particularly with regard to food and nutrition. Design/methodology/approach - Based on empirical data generated over the course of one year of fieldwork in three rural...... – The study contributes to an understanding of policy implementation and the implications of a HPS approach to health education and health promotion in small rural schools....

  5. 78 FR 41795 - Farm, Ranch, and Rural Communities Committee Teleconference

    Science.gov (United States)

    2013-07-11

    ... Communities Committee Teleconference AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of Public..., EPA gives notice of a teleconference meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...

  6. Indigenous knowledge of Rural Communities for Combating Climate ...

    African Journals Online (AJOL)

    HP

    and extremes, suppress diseases and crop pests and usd to conserve soil moisture so as to increase ..... materials such as leaves, grass clippings, kitchen scraps and yard wastes. As a result, ... consumption in urban and rural communities.

  7. Childbirth in a rural highlands community in Papua New Guinea: a descriptive study.

    Science.gov (United States)

    Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Vallely, Andrew; Homer, Caroline S E; Whittaker, Andrea

    2015-03-01

    to explore men's and women's experiences, beliefs and practices surrounding childbirth in a rural highlands community in Papua New Guinea. a qualitative study comprising focus group discussions, key informant and in depth interviews. the study was undertaken in a rural community in Eastern Highlands Province, Papua New Guinea. 51 women and 26 men participated in 11 focus group discussions. Key informant and in depth interviews were undertaken with 21 women and five men. both women and men recognised the importance of health facility births, linking village births with maternal and newborn deaths. Despite this, many women chose to give birth in the community in circumstances influenced by cultural and customary beliefs and practices. Women giving birth in the community frequently gave birth in an isolated location. Traditional beliefs surrounding reasons for difficult births, including spiritual beliefs were reported along with the use of traditional methods used to help prolonged and difficult births. while the importance of health facility births is recognised in this rural community many women continue to give birth in the village. Identifying and understanding local customs, beliefs and practices, particularly those that may be harmful to women and their newborn infants, is critical to the development of locally-appropriate community-based strategies for improving maternal and infant health in rural communities in PNG and other resource-limited, high burden settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Self-recognition of mental health problems in a rural Australian sample.

    Science.gov (United States)

    Handley, Tonelle E; Lewin, Terry J; Perkins, David; Kelly, Brian

    2018-04-19

    Although mental health literacy has increased in recent years, mental illness is often under-recognised. There has been little research conducted on mental illness in rural areas; however, this can be most prominent in rural areas due to factors such as greater stigma and stoicism. The aim of this study is to create a profile of those who are most and least likely to self-identify mental health problems among rural residents with moderate- to-high psychological distress. Secondary analysis of a longitudinal postal survey. Rural and remote New South Wales, Australia. Four-hundred-and-seventy-two community residents. Participants completed the K10 Psychological Distress Scale, as well as the question 'In the past 12 months have you experienced any mental health problems?' The characteristics of those who reported moderate/high distress scores were explored by comparing those who did and did not experience mental health problems recently. Of the 472 participants, 319 (68%) with moderate/high distress reported a mental health problem. Reporting a mental health problem was higher among those with recent adverse life events or who perceived more stress from life events while lower among those who attributed their symptoms to a physical cause. Among a rural sample with moderate/high distress, one-third did not report a mental health problem. Results suggest a threshold effect, whereby mental health problems are more likely to be acknowledged in the context of additional life events. Ongoing public health campaigns are necessary to ensure that symptoms of mental illness are recognised in the multiple forms that they take. © 2018 National Rural Health Alliance Ltd.

  9. Marine wildlife entanglement: Assessing knowledge, attitudes, and relevant behaviour in the Australian community

    International Nuclear Information System (INIS)

    Pearson, Elissa; Mellish, Sarah; Sanders, Ben; Litchfield, Carla

    2014-01-01

    Highlights: • Marine debris and marine wildlife entanglement remains a significant global issue. • We examined awareness of this issue in an Australian community sample. • Findings reveal gaps exist in terms of what entanglement is and the risks posed. • Enhancing community understanding may facilitate greater conservation action. • The ‘Seal the Loop’ initiative provides one potential mechanism for such education. - Abstract: Marine debris remains a global challenge, with significant impacts on wildlife. Despite this, there is a paucity of research examining public understanding about marine wildlife entanglement [MWE], particularly within an Australian context. The present study surveyed two hundred and thirteen participants across three coastal sites to assess familiarity with MWE and the effectiveness of a new community education initiative ‘Seal the Loop’ [STL]. Results revealed attitudes toward marine wildlife were very positive (M 40.5, SD 4.12); however 32% of participants were unable to correctly explain what MWE is and risks to wildlife were under-estimated. STL may be one method to enhance public understanding and engagement-if community familiarity with the program can be increased. For those aware of STL (<13% of the sample at the time of the study), findings revealed this was having a positive impact (e.g. learning something new, changed waste disposal behaviours)

  10. Mobile bone densitometry service in rural South Australia

    International Nuclear Information System (INIS)

    Tucker, K.N.; Schultz, C.G.; Chatterton, B.E.

    1997-01-01

    Full text: Twenty per cent of South Australia's population live rurally, with limited access to modern medical services. The Mobile Bone Densitometry Unit was established to address this problem. The Unit began in 1994 with cooperation from private industry. In fostering the service, many issues were addressed, including choice of appropriate sites; selection of a liaison person at each site; towing of the Unit; transportation and accommodation of staff; education of local health professionals and community members; promotion of the service to the community: and timely reporting of results to referring doctors. The scanner is an Hologic ODR-1000+ densitometer, housed in a 5.9 1.8 metre, 2200 kg caravan. It is necessary to reduce vibration and motion during travel, control the internal environment, and have an electrically clean power supply. Addressing these parameters result in the critical value for quality control being 2500 patients, averaging 13 patients/working day. The mean age of the patients was 64 y (range 30-90 y), with 93 % of patients being >50 y. Results show a normally distributed Z score, suggesting that non-selected 'normal' population is being studied and the Hologic normal range matches that of the South Australian rural community. Local communities have utilised the service to full capacity resulting in future visits being extended. In conclusion, it is possible to provide a high quality, reliable bone densitometry service to rural communities

  11. An evaluation of the role of rural primary school teachers in community development tasks in southern Sudan

    OpenAIRE

    Ngalam, Jabi Jack

    1987-01-01

    This thesis investigates the role of rural primary school teachers in community development activities within an integrated rural education centres project (IRECs) in southern Sudan. The study explores five areas of importance for an extended teacher's role in rural areas: (i) the school or community environment, (ii) community perception of the teacher's role and its expectations of the school, (iii) teachers' perception of their own role in the community, (iv) teachers' ...

  12. An investigation into possibilities for implementation of a virtual community of practice delivered via a mobile social network for rural community media in the Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Oliva Muwanga-Zake

    2017-03-01

    Full Text Available Background: The purpose of this article is to provide an overview of how a virtual community of practice can be delivered via a mobile social networking framework to support rural community media in the Eastern Cape Province of South Africa. Objectives: The article presents the results of a study conducted to ascertain the possibilities of utilising mobile social networking as a means to provide access to required information and knowledge to rural community media through creation of a virtual community of practice. Improving the operational effectiveness of rural community media as a component of the rural community communication process would serve to improve the entire rural community communication process as well, making them more effective tools for availing relevant news and information to rural communities and reflecting the realities of rural communities to their broader environment. Method: The study was conducted on rural community media small micro and medium enterprises (SMMEs in the Eastern Cape Province of South Africa. The study applied an interpretive research philosophy, qualitative research design and multiple–case study approach. Primary data were collected through semi-structured interviews supported by a questionnaire, with secondary data collected via literature review, observation and documentation analysis. Results: Findings were that rural community media do make use of social media and mobile devices in operating their business, require access to generic and domain specific support services and actively engage their peers and stakeholders in this respect, although no formalised structure existed. The authors’ recommendation is to create a formalised virtual community of practice through the establishment of a mobile social network. Conclusion: Because of the fact that rural community SMMEs already utilise mobile devices and social media to operate their businesses, development of a solution based on a mobile social

  13. Factors that motivate young pharmacists to work in rural communities in the Ukraine.

    Science.gov (United States)

    Anzenberger, Peter; Popov, Sergey B; Ostermann, Herwig

    2011-01-01

    A number of identified factors can influence clinicians' location of practice decisions; however, little is known about the location decisions of pharmacists. In general, males are more likely to work in rural and remote regions, and students with a rural background are more likely to work in rural communities after graduation. In the Ukraine, pharmaceutical health care is important because a patient's first visit is often to the pharmacy, rather than to a GP. This study sought to understand what motivates Ukraine pharmacy students to practice in rural areas. The first part of the study used a quantitative design with questionnaires based on Füglistaller's model for measuring the motivation of entrepreneurs, because working in a rural Ukraine pharmacy means, in most cases, operating a privately owned pharmacy. The second part was qualitative to verify these results. The students' motivation to work in rural areas after graduation depended on their sex and place of birth, but this was not decisive. More influential were the factors that motivate operating a privately owned pharmacy. Within the group that considered working in a privately owned pharmacy in a rural community, motivation was more intrinsic (eg enjoys helping people), while negative factors were more external (eg financial risk). Students from the National University of Pharmacy in Kharkiv comprise the majority of pharmacists in the Ukraine. They are interested in working in a rural area as long as opportunities align with their individual expectations. The two main factors found that would supply more young graduates to rural areas were: (1) improving rural living conditions; and (2) fostering the mental attitude required for operating a private pharmacy. In addition, decreasing related bureaucracy, and increasing financial and fiscal grants may enhance medical and pharmaceutical health care in rural communities of the Ukraine.Key words: graduate pharmacists, living conditions, motivation, privately

  14. Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities

    Science.gov (United States)

    Butler, Karen M.; Wiggins, Amanda T.; Kostygina, Ganna; Langley, Ronald E.; Hahn, Ellen J.

    2016-01-01

    Abstract Introduction: Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Methods: Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Results: Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Conclusions: Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Implications: Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing

  15. Appropriate Health Promotion for Australian Aboriginal and Torres Strait Islander Communities

    DEFF Research Database (Denmark)

    Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian

    2012-01-01

    building, community empowerment and local ownership. Culturally-Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization (Geneva) and Global Alliance for Health Promotion. It guides community-focused health promotion practice built on and shaped...... by the respect, understanding and utilisation of local knowledge and culture. Culturally-Appropriate Health Promotion is not about ‘targeting’, ‘intervening’ or ‘responding’. Rather, it results in health program planners and policy-makers understanding, respecting, empowering and collaborating with communities......, and their socio-cultural environment, towards better health. This commentary aims to examine and apply the 8 principles of Culturally-Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes its widespread adoption as a framework for a more respectful...

  16. Adoption of community engagement in the corporate culture of Australian forest plantation companies

    NARCIS (Netherlands)

    Gordon, M.; Lockwood, M.; Schirmer, Jacki; Vanclay, F.; Hanson, D.

    2013-01-01

    This paper provides practical insight into what can be done to improve the adoption of community engagement (CE) in the corporate culture of two Australian forest plantation companies. Previous research has identified that CE can be limited by corporate cultures that promote a narrow range of CE

  17. Ageing in rural China: impacts of increasing diversity in family and community resources.

    Science.gov (United States)

    Joseph, A E; Phillips, D R

    1999-06-01

    The majority of China's population lives in rural areas and a pattern is emerging of very uneven provision of support for rural elderly people. Local economic conditions and broad demographic trends are creating diversity in the ability both of rural families to care for their elderly kin and in the capacity of communities to support their elderly residents and family carers. In part as a consequence of China's population policy and the 'one-child policy', future Chinese families will have fewer members and be 'older', but they will continue to be regarded emotionally and in policy as the main source of economic and social support for the elderly. The increasing involvement of women in the paid workforce and the changing geographical distribution of family members resulting from work-related migration, are reducing the ability of families to care for their elderly relatives. The availability of resources other than the family for the care of older persons therefore becomes a key issue. Communities in more prosperous, modernising rural areas are often able to provide their elderly residents with welfare and social benefits previously found almost exclusively in urban areas. However, in poorly developed rural areas, provision is either very patchy or non-existent and the local economy cannot support expansion or improvement. A case study in Zhejiang Province illustrates the favourable provision for ageing in a prosperous modernising rural community, in which entitled elderly residents are provided with an impressive array of financial and social benefits. The paper concludes with a consideration of the policy implications of the growing differentiation of the social and economic capacity of rural communities to support their elderly members.

  18. What community characteristics help or hinder rural communities in becoming age-friendly? Perspectives from a Canadian prairie province.

    Science.gov (United States)

    Spina, John; Menec, Verena H

    2015-06-01

    Age-friendly initiatives are increasingly promoted as a policy solution to healthy aging, The primary objective of this article was to examine older adults' and key stakeholders' perceptions of the factors that either help or hinder a community from becoming age-friendly in the context of rural Manitoba, a Canadian prairie province. Twenty-four older adults and 17 key informants completed a qualitative interview. The findings show that contextual factors including size, location, demographic composition, ability to secure investments, and leadership influence rural communities' ability to become age-friendly. Government must consider the challenges these communities face in becoming more age-friendly and develop strategies to support communities. © The Author(s) 2013.

  19. Resilience in Rural Community-Dwelling Older Adults

    Science.gov (United States)

    Wells, Margaret

    2009-01-01

    Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…

  20. Decentralization and Educational Performance: Evidence from the PROHECO Community School Program in Rural Honduras

    Science.gov (United States)

    Di Gropello, Emanuela; Marshall, Jeffery H.

    2011-01-01

    We analyze the effectiveness of the Programa Hondureno de Educacion Comunitaria (PROHECO) community school program in rural Honduras. The data include standardized tests and extensive information on school, teacher, classroom and community features for 120 rural schools drawn from 15 states. Using academic achievement decompositions we find that…

  1. Small rural communities in the inland Northwest: an assessment of small communities in the interior and upper Columbia River basins.

    Science.gov (United States)

    Charles C. Harris; William McLaughlin; Greg Brown; Dennis R. Becker

    2000-01-01

    An assessment of small rural communities in the interior and upper Columbia River basin was conducted for the Interior Columbia Basin Ecosystem Management Project (ICBEMP). The characteristics and conditions of the rural communities in this region, which are complex and constantly changing, were examined. The research also assessed the resilience of the region’s...

  2. Epidemiology of stroke in a rural community in Southeastern Nigeria

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    Enwereji KO

    2014-06-01

    Full Text Available Kelechi O Enwereji,1 Maduaburochukwu C Nwosu,1 Adesola Ogunniyi,2 Paul O Nwani,1 Azuoma L Asomugha,1 Ezinna E Enwereji3 1Neurology Unit, Department of Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria; 2Neurology Unit, Department of Medicine, University College Hospital Ibadan, Oyo State, Nigeria; 3Department of Community Medicine/Nursing Sciences, College of Medicine, Abia State University, Uturu, Abia State, Nigeria Background: The prevalence and incidence of stroke vary from community to community worldwide. Nonetheless, not much is known about the current epidemiology of stroke in rural Nigeria and indeed Africa. Methods: We carried out a two-phase door-to-door survey in a rural, predominantly low-income, community in Anambra, Southeastern Nigeria. We used a modified World Health Organization (WHO protocol for detecting neurological diseases in the first phase, and a stroke-specific questionnaire and neurological examination in the second phase. An equal number of sex- and age-matched stroke-negative subjects were examined. Results: We identified ten stroke subjects in the study. The crude prevalence of stroke in rural Nigeria was 1.63 (95% confidence interval [CI] 0.78–3.00 per 1,000 population. The crude prevalence of stroke in males was 1.99 (95% CI 0.73–4.33 per 1,000, while that for females was 1.28 (95% CI 0.35–3.28 per 1,000 population. The peak age-specific prevalence of stroke was 12.08 (95% CI 3.92–28.19 per 1,000, while after adjustment to WHO world population, the peak was 1.0 (95% CI 0.33–2.33 per 1,000. Conclusion: The prevalence of stroke was found to be higher than previously documented in rural Nigeria, with a slightly higher prevalence in males than females. This is, however, comparable to data from rural Africa. Keywords: Africa, developing country, prevalence

  3. The complexity of rural contexts experienced by community disability workers in three southern African countries

    Directory of Open Access Journals (Sweden)

    Margaret Booyens

    2015-06-01

    Full Text Available An understanding of rural communities is fundamental to effective community-based rehabilitation work with persons with disabilities. By removing barriers to community participation, persons with disabilities are enabled to satisfy their fundamental human needs. However, insufficient attention has been paid to the challenges that rural community disability workers (CDWs face in trying to realise these objectives. This qualitative interpretive study, involving in-depth interviews with 16 community disability workers in Botswana, Malawi and South Africa, revealed the complex ways in which poverty, inappropriately used power and negative attitudes of service providers and communities combine to create formidable barriers to the inclusion of persons with disabilities in families and rural communities. The paper highlights the importance of understanding and working with the concept of ‘disability’ from a social justice and development perspective. It stresses that by targeting attitudes, actions and relationships, community disability workers can bring about social change in the lives of persons with disabilities and the communities in which they live.

  4. Assessment of community led total sanitation uptake in rural Kenya ...

    African Journals Online (AJOL)

    Background: Community Led Total Sanitation (CLTS) is an innovative community led drive to set up pit latrines in rural Kenya with an aim of promoting sustainable sanitation through behaviour change. It's a behaviour change approach based on social capital that triggers households to build pit latrines without subsidy.

  5. Innovation technological energetics in rural communities. Case of study community of “Manantiales”, Villa Clara, Cuba

    Directory of Open Access Journals (Sweden)

    Raul Olalde Font

    2016-10-01

    Full Text Available This investigation is framed in the analysis of impacts in the local development starting from the taking of decisions on projects of rural energy in Cuban communities that have as economic main activity the agricultural sector, illustrated the results of a case study where the technological most viable options are selected under the optics of the improvement of indicators of community resources. The methods and used materials are characteristic of a field work with application model are characterized for the taking of decisions in the energy area and their sources SURE, as geographical region the community isolated rural “Manantiales” linked to the agrarian sector in the republic of Cuba and the present period review in the thematic one approached. The main indicators are sketched in each resource of the rural community under the optics of the SURE in their version 3.0, as well the characterization of the prediction of the impacts at each technological option on the resources, is exhibited a mean of impacts and the classification of the technologies according to the level of achievements contribute to the indicators of community resources, obtaining as a result that the hydro energy technology is the most viable option with a value of 100 points in the scale from 0 to 100, followed by the GRID with 91.11 and of the photovoltaic systems based on silicon panels with 90.57, in this case all technologies contribute a significant level of achievements to the local community development.

  6. Perception of blindness and blinding eye conditions in rural communities.

    Science.gov (United States)

    Ashaye, Adeyinka; Ajuwon, Ademola Johnson; Adeoti, Caroline

    2006-01-01

    PURPOSE: The purpose of this qualitative study was to explore the causes and management of blindness and blinding eye conditions as perceived by rural dwellers of two Yoruba communities in Oyo State, Nigeria. METHODS: Four focus group discussions were conducted among residents of Iddo and Isale Oyo, two rural Yoruba communities in Oyo State, Nigeria. Participants consisted of sighted, those who were partially or totally blind and community leaders. Ten patent medicine sellers and 12 traditional healers were also interviewed on their perception of the causes and management of blindness in their communities. FINDINGS: Blindness was perceived as an increasing problem among the communities. Multiple factors were perceived to cause blindness, including germs, onchocerciasis and supernatural forces. Traditional healers believed that blindness could be cured, with many claiming that they had previously cured blindness in the past. However, all agreed that patience was an important requirement for the cure of blindness. The patent medicine sellers' reports were similar to those of the traditional healers. The barriers to use of orthodox medicine were mainly fear, misconception and perceived high costs of care. There was a consensus of opinion among group discussants and informants that there are severe social and economic consequences of blindness, including not been able to see and assess the quality of what the sufferer eats, perpetual sadness, loss of sleep and dependence on other persons for daily activities. CONCLUSION: Local beliefs associated with causation, symptoms and management of blindness and blinding eye conditions among rural Yoruba communities identified have provided a bridge for understanding local perspectives and basis for implementing appropriate primary eye care programs. PMID:16775910

  7. Understanding social capital and HIV risk in rural African American communities.

    Science.gov (United States)

    Cené, Crystal W; Akers, Aletha Y; Lloyd, Stacey W; Albritton, Tashuna; Powell Hammond, Wizdom; Corbie-Smith, Giselle

    2011-07-01

    African Americans (AA) and rural communities often suffer disproportionately from poorer health. Theory-guided research examining how individual- and community-level factors influence health behaviors and contribute to disparities is needed. To understand how a social network model that captures the interplay between individual and community factors might inform community-based interventions to reduce HIV risk in rural AA communities. Qualitative study. Eleven focus groups with 38 AA 16-24 year olds, 42 adults over age 25, and 13 formerly incarcerated individuals held in community settings in two rural, predominantly AA counties in North Carolina. Thirty-seven semi-structured interviews with multiethnic key informants. Semi-structured interviews and focus groups with open-ended questions assessed a) perceptions of multi-level HIV risk determinants from a social network model (individual, interpersonal, social, economic, political and structural) identified through literature review and b) community needs and assets affecting local HIV rates. Qualitative data was analyzed using directive content analysis guided by a social network model. We identified four themes regarding the interaction between individuals and their communities that mediate HIV risk: interpersonal processes, community structural environment, social disorder, and civic engagement. Communities were characterized as having a high degree of cohesiveness, tension, and HIV-related stigma. The community structural environment-characterized by neighborhood poverty, lack of skilled jobs, segregation, political disenfranchisement and institutional racism-was felt to reduce the availability and accessibility of resources to combat HIV. Adults noted an inability to combat social problems due to social disorder, which fuels HIV risk behaviors. Civic engagement as a means of identifying community concerns and developing solutions is limited by churches' reluctance to address HIV-related issues. To combat HIV

  8. "Hey, I Saw Your Grandparents at Walmart": Teacher Education for Rural Schools and Communities

    Science.gov (United States)

    Eppley, Karen

    2015-01-01

    This is a case study about how teacher education might better prepare rural teacher candidates for rural schools. Parents, teachers, community members, and students associated with a rural school described what is important in the preparation of teachers for today's rural schools. Their goals and wishes for their children's school and community…

  9. Building a community of practice in rural medical education: growing our own together.

    Science.gov (United States)

    Longenecker, Randall L; Schmitz, David

    2017-01-01

    This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice. However, by the 1980s, these programs were not yet producing the desired numbers of rural physicians. In response, in 1986, Maudlin and others at the family medicine residency in Spokane developed the first 1-2 RTT in Colville, Washington. In the 1990s, and by 2000, early news of success led to a peak of 35 active programs. However, over the next decade these programs experienced significant hardship due to a lack of funding and a general decline in student interest in family medicine. By 2010, only 25 programs remained. In 2010, in an effort to sustain the 1-2 RTT as a national strategy in training physicians for rural practice, a federally funded consortium of individuals and programs established the RTT Technical Assistance program (RTT TA). Building on the pattern of peer support and collaboration set by earlier groups, the RTT TA consortium expanded the existing community of practice in rural medical education in support of RTTs. In-person meetings, peer consultation and visitation, coordinated efforts at student recruitment, and collaborative rural medical education research were all elements of the consortium's strategy. Rather than anchoring its efforts in medical schools or hospitals, this consortium engaged as partners a wider variety of stakeholders. This included physician educators still living and practicing in rural communities ('local experts'), rural medical educator peers, program directors

  10. A comparison of barriers to accessing services for mental and physical health conditions in a sample of rural Australian adults.

    Science.gov (United States)

    Fennell, Kate; Hull, Melissa; Jones, Martin; Dollman, James

    2018-02-01

    The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults. A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview. They were presented a physical or mental health scenario and rated the extent to which barriers would prevent them from seeking help for that condition. Responses ranged from 1 ('strongly disagree') to 5 ('strongly agree') and were averaged to form domain scores (higher scores representing stronger barriers to seeking support), in addition to being examined at the item level. Men reported higher barriers for the mental compared with physical health scenario across four domains ('need for control and self-reliance', 'minimising the problem, resignation and normalisation', 'privacy' and 'emotional control'). Women reported higher barriers for the mental compared to physical health scenario in two domains ('need for control and self-reliance' and 'privacy'). Both men and women endorsed many items in the mental health context (eg 'I don't like feeling controlled by other people', 'I wouldn't want to overreact to a problem that wasn't serious', 'Problems like this are part of life; they're just something you have to deal with', 'I'd prefer just to put up with it rather than dwell on my problems', 'Privacy is important to me, and I don't want other people to know about my problems' and 'I don't like to get emotional about things') but in the physical health context, barriers were endorsed only by men (eg 'I wouldn't want to overreact to a problem that wasn't serious',' I'd prefer just to put up with it rather than dwell on my problems', 'Problems like this are part of life; they're just something

  11. Provisioning of game meat to rural communities as a benefit of sport hunting in Zambia.

    Directory of Open Access Journals (Sweden)

    Paula A White

    Full Text Available Sport hunting has reportedly multiple benefits to economies and local communities; however, few of these benefits have been quantified. As part of their lease agreements with the Zambia Wildlife Authority, sport hunting operators in Zambia are required to provide annually to local communities free of charge i.e., provision a percentage of the meat obtained through sport hunting. We characterized provisioning of game meat to rural communities by the sport hunting industry in Zambia for three game management areas (GMAs during 2004-2011. Rural communities located within GMAs where sport hunting occurred received on average > 6,000 kgs per GMA of fresh game meat annually from hunting operators. To assess hunting industry compliance, we also compared the amount of meat expected as per the lease agreements versus observed amounts of meat provisioned from three GMAs during 2007-2009. In seven of eight annual comparisons of these GMAs, provisioning of meat exceeded what was required in the lease agreements. Provisioning occurred throughout the hunting season and peaked during the end of the dry season (September-October coincident with when rural Zambians are most likely to encounter food shortages. We extrapolated our results across all GMAs and estimated 129,771 kgs of fresh game meat provisioned annually by the sport hunting industry to rural communities in Zambia at an approximate value for the meat alone of >US$600,000 exclusive of distribution costs. During the hunting moratorium (2013-2014, this supply of meat has halted, likely adversely affecting rural communities previously reliant on this food source. Proposed alternatives to sport hunting should consider protein provisioning in addition to other benefits (e.g., employment, community pledges, anti-poaching funds that rural Zambian communities receive from the sport hunting industry.

  12. Provisioning of game meat to rural communities as a benefit of sport hunting in Zambia.

    Science.gov (United States)

    White, Paula A; Belant, Jerrold L

    2015-01-01

    Sport hunting has reportedly multiple benefits to economies and local communities; however, few of these benefits have been quantified. As part of their lease agreements with the Zambia Wildlife Authority, sport hunting operators in Zambia are required to provide annually to local communities free of charge i.e., provision a percentage of the meat obtained through sport hunting. We characterized provisioning of game meat to rural communities by the sport hunting industry in Zambia for three game management areas (GMAs) during 2004-2011. Rural communities located within GMAs where sport hunting occurred received on average > 6,000 kgs per GMA of fresh game meat annually from hunting operators. To assess hunting industry compliance, we also compared the amount of meat expected as per the lease agreements versus observed amounts of meat provisioned from three GMAs during 2007-2009. In seven of eight annual comparisons of these GMAs, provisioning of meat exceeded what was required in the lease agreements. Provisioning occurred throughout the hunting season and peaked during the end of the dry season (September-October) coincident with when rural Zambians are most likely to encounter food shortages. We extrapolated our results across all GMAs and estimated 129,771 kgs of fresh game meat provisioned annually by the sport hunting industry to rural communities in Zambia at an approximate value for the meat alone of >US$600,000 exclusive of distribution costs. During the hunting moratorium (2013-2014), this supply of meat has halted, likely adversely affecting rural communities previously reliant on this food source. Proposed alternatives to sport hunting should consider protein provisioning in addition to other benefits (e.g., employment, community pledges, anti-poaching funds) that rural Zambian communities receive from the sport hunting industry.

  13. Improving healthcare for Aboriginal Australians through effective engagement between community and health services.

    Science.gov (United States)

    Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

    2016-07-07

    Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians. The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation. Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were

  14. Promoting youth physical activity in rural southern communities: practitioner perceptions of environmental opportunities and barriers.

    Science.gov (United States)

    Edwards, Michael B; Theriault, Daniel S; Shores, Kindal A; Melton, Karen M

    2014-01-01

    Research on youth physical activity has focused on urban areas. Rural adolescents are more likely to be physically inactive than urban youth, contributing to higher risk of obesity and chronic diseases. Study objectives were to: (1) identify perceived opportunities and barriers to youth physical activity within a rural area and (2) identify rural community characteristics that facilitate or inhibit efforts to promote youth physical activity. Thirty in-depth interviews were conducted with expert informants in 2 rural southern US counties. Interviewees were recruited from diverse positions across multiple sectors based on their expert knowledge of community policies and programs for youth physical activity. Informants saw ball fields, natural amenities, and school sports as primary resources for youth physical activity, but they were divided on whether opportunities were abundant or scarce. Physical distance, social isolation, lack of community offerings, and transportation were identified as key barriers. Local social networks facilitated political action and volunteer recruitment to support programs. However, communities often lacked human capital to sustain initiatives. Racial divisions influenced perceptions of opportunities. Despite divisions, there were also examples of pooling resources to create and sustain physical activity opportunities. Developing partnerships and leveraging local resources may be essential to overcoming barriers for physical activity promotion in rural areas. Involvement of church leaders, school officials, health care workers, and cooperative extension is likely needed to establish and sustain youth rural physical activity programs. Allocating resources to existing community personnel and volunteers for continuing education may be valuable. © 2014 National Rural Health Association.

  15. DISTANCE EDUCATION POTENTIAL FOR A CANADIAN RURAL ISLAND COMMUNITY

    Directory of Open Access Journals (Sweden)

    Tom JONES

    2009-04-01

    Full Text Available The purpose of the study was to investigate the potential impact of distance education on a small, rural, Canadian island community. Presently, the population of small, rural island communities on the west coast of Canada are facing numerous challenges to retain and to attract permanent residents and families and to provide support and direction for those residents who wish to pursue K-12 accreditation, post-secondary education, vocational/trades training and up-grading or life-long learning. A unique set of considerations confront many of these isolated communities if they wish to engage in distance education and training. This set ranges from internet access to excessive travel by secondary students to the lack of centralized facility. For this study, a group of 48 participants were interviewed to determine their perceptions of the potential for distance education to impact on the community's educational, both academic and vocational, life-long learning and economic needs. The results indicated that there were four general areas of purported benefit: academic advancement, an improved quality of life, support for young families and a stabilizing affect on the local economy. Suggestions for the implementation of a suitable distance education resource are noted.

  16. Factors Affecting Drug Abuse in Adolescent Females in Rural Communities

    Science.gov (United States)

    Renes, Susan L.; Strange, Anthony T.

    2009-01-01

    This article explores factors influencing adolescent female substance use in rural communities. Self-reported data gathered from females 12 to 15 years of age in two northwestern communities in the United States showed an association among gender identity, peer and parental relationships, and substance use. Aggressive masculinity had the strongest…

  17. Developing Leaders: The Role of Competencies in Rural Community Colleges

    Science.gov (United States)

    Eddy, Pamela L.

    2013-01-01

    Pending retirements underscore the need to develop community college campus leaders. Rural community colleges will be particularly hard-hit by changes in leadership as they represent the majority of 2-year colleges and face unique challenges given their location. To help address the anticipated leadership transition, the American Association of…

  18. The relationship of primary care providers to dental practitioners in rural and remote Australia.

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2017-08-01

    Rural residents have poorer oral health and more limited access to dental services than their city counterparts. In rural communities, health care professionals often work in an extended capacity due to the needs of the community and health workforce shortages in these areas. Improved links and greater collaboration between resident rural primary care and dental practitioners could help improve oral health service provision such that interventions are both timely, effective and lead to appropriate follow-up and referral. This study examined the impact oral health problems had on primary health care providers; how primary care networks could be more effectively utilised to improve the provision of oral health services to rural communities; and identified strategies that could be implemented to improve oral health. Case studies of 14 rural communities across three Australian states. Between 2013 and 2016, 105 primary and 12 dental care providers were recruited and interviewed. Qualitative data were analysed in Nvivo 10 using thematic analysis. Quantitative data were subject to descriptive analysis using SPSSv20. Rural residents presented to primary care providers with a range of oral health problems from "everyday" to "10 per month". Management by primary care providers commonly included short-term pain relief, antibiotics, and advice that the patient see a dentist. The communication between non-dental primary care providers and visiting or regional dental practitioners was limited. Participants described a range of strategies that could contribute to better oral health and oral health oral services in their communities. Rural oral health could be improved by building oral health capacity of non-dental care providers; investing in oral health promotion and prevention activities; introducing more flexible service delivery practices to meet the dental needs of both public and private patients; and establishing more effective communication and referral pathways between

  19. Community Development as an Approach to Community Engagement in Rural-Based Higher Education Institutions in South Africa

    Science.gov (United States)

    Netshandama, V. O.

    2010-01-01

    The premise of this article is that the "jury is still out" to describe what effective Community Engagement entails in South African higher education institutions. The current discussions about community engagement and service learning do not cover the primary objective of adding value to the community, particularly of the rural-based…

  20. The shelf space and strategic placement of healthy and discretionary foods in urban, urban-fringe and rural/non-metropolitan Australian supermarkets.

    Science.gov (United States)

    Cameron, Adrian J

    2018-02-01

    Supermarkets are a key influence on eating behaviours, but it is unknown if the promotion of food within stores varies on a geographic gradient from urban, to urban-fringe and non-metropolitan areas. The present study aimed to assess the shelf space and strategic placement of healthy and discretionary foods in each of urban, urban-fringe and non-metropolitan Australian supermarkets. Design/Setting In-store audits were conducted in stores from one of the two major Australian supermarket chains in urban (n 19), urban-fringe (n 20) and non-metropolitan (n 26) areas of Victoria. These audits examined selected food items (crisps/chips, chocolate, confectionery, soft drinks/sodas, fruits and vegetables) and measured the shelf space and the proportion of end-of-aisle and cash register displays containing these products. Store size was measured as the sum of aisle length. Differences in the supermarket food environment with respect to location were assessed, before and after adjustment for neighbourhood socio-economic position. The strategic placement of discretionary foods was commonly observed in all supermarkets. Adjusting for store size (larger in urban-fringe and rural areas), urban stores had greater shelf space devoted to fruits and vegetables, and less checkouts with soft drinks, than urban-fringe and rural/non-metropolitan areas. Differences remained following adjustment for neighbourhood socio-economic position. No clear pattern was observed for end-of-aisle displays, or the placement of chocolate and confectionery at checkouts. The shelf space of healthy and discretionary foods in urban-fringe and rural stores parallels the prevalence of overweight and obesity in these areas. Interventions in urban-fringe and rural stores targeting the shelf space of healthy foods and the placement of soft drinks at key displays may be useful obesity prevention initiatives.

  1. "I like talking to people on the computer": Outcomes of a home-based intervention to develop social media skills in youth with disabilities living in rural communities.

    Science.gov (United States)

    Raghavendra, Parimala; Hutchinson, Claire; Grace, Emma; Wood, Denise; Newman, Lareen

    2018-05-01

    To investigate the effectiveness of a home-based social media use intervention to enhance the social networks of rural youth with disabilities. Participants were nine youth (mean age = 17.0 years) with disabilities from two rural Australian communities. The intervention consisted of providing appropriate assistive technology and social media training on individualised goals. Using mixed methods, quantitative (a single group pre-post) and qualitative (interviews with participants and their carers) measures were used to examine outcomes of training, individual experiences of the intervention, and changes to online social networks. Participants increased their performance and satisfaction with performance on social media problem areas post-intervention; paired t-tests showed statistical significance at p social participation, independence and improvements to literacy. Ongoing parental concerns regarding cyber safety and inappropriate online content were noted. The findings suggest that social media training is a feasible method for increasing social networks among rural-based youth with disabilities. To sustain ongoing benefits, parents need knowledge and training in integrating assistive technology and social media. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Lack of association between drought and mental health in a cohort of 45-61 year old rural Australian women.

    Science.gov (United States)

    Powers, Jennifer R; Dobson, Annette J; Berry, Helen L; Graves, Anna M; Hanigan, Ivan C; Loxton, Deborah

    2015-12-01

    To evaluate the impact of drought on the mental health of rural Australian women and those in vulnerable sub-populations: women who were more isolated, poorer and less educated; and women who had histories of chronic disease or poor mental health. Surveys were mailed in 1996, 1998, 2001, 2004 and 2008 to 6,664 women born between 1946 and1951 who were participating in the Australian Longitudinal Study on Women's Health. The surveys included the Mental Health Index of the Medical Outcomes Study Short-Form 36 (MHI). Drought was assessed by linking the latitude and longitude of women's place of residence at each survey to the Hutchinson Drought Index. Associations between MHI and drought were assessed using linear mixed-models. While 31% of the women experienced drought in 1998 and 50% experienced drought in 2007; experience of droughts was less common in the other years. Although drought varied from survey year to survey year, mental health did not vary with drought conditions for rural women or vulnerable sub-populations. These findings are contrary to the long-held assumption that droughts increase mental health problems in Australia. While similar results may not be true for men, empirical evidence (rather than assumptions) is required on associations between drought and mental health. © 2015 Public Health Association of Australia.

  3. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  4. Malaria elimination practices in rural community residents in ...

    African Journals Online (AJOL)

    53. Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 1, 2015. Malaria elimination practices in rural community residents in Rwanda: A cross sectional study ... is an entirely preventable and treatable disease, provided that effective .... The most way used for malaria prevention, control and elimination.

  5. Community perceptions of a rural medical school : a pilot qualitative study

    NARCIS (Netherlands)

    Nestel, Debra; Gray, Katherine; Simmons, Margaret; Pritchard, Shane A; Islam, Rumana; Eng, Wan Q; Ng, Adrian; Dornan, Tim

    2014-01-01

    BACKGROUND: This paper explores local community perceptions of a relatively new rural medical school. For the purposes of this paper, community engagement is conceptualized as involvement in planning, delivering, and evaluating the medical program. Although there are several reviews of patient

  6. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

    Science.gov (United States)

    Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

    2016-01-01

    It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately

  7. Program of active aging in a rural Mexican community: a qualitative approach

    OpenAIRE

    Mendoza-Núñez Víctor; Correa-Muñoz Elsa; de la Luz Martínez-Maldonado María

    2007-01-01

    Abstract Background Education is one of the key elements in the promotion of a thorough paradigm for active aging. The aim of this study is to analyze factors that contribute the empowerment of older adults in a rural Mexican community and, thus, promote active aging. Methods The study was conducted in a rural Mexican community (Valle del Mezquital), based on an action-research paradigm. One hundred and fifty-five elderly subjects with elementary school education participated in a formal trai...

  8. Aboriginal women in rural Australia; a small study of infant feeding behaviour.

    Science.gov (United States)

    Helps, Catherine; Barclay, Lesley

    2015-06-01

    Aboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities. To explore the factors impacting upon infant feeding choices in a rural Aboriginal Community. Semi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results. Three key themes were identified. These were "I'm doing the best thing for..." which encompasses the motivations underpinning infant feeding decisions; "this is what I know..." which explores individual and community knowledge regarding infant feeding; and "a safe place to feed" identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today. Aboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study. Efforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can

  9. An exploration of the longer-term impacts of community participation in rural health services design.

    Science.gov (United States)

    Farmer, Jane; Currie, Margaret; Kenny, Amanda; Munoz, Sarah-Anne

    2015-09-01

    This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008-2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project. Only one direct sustained service change was found - introduction of a volunteer first responder scheme in one community. Sustained changes in knowledge were found. The Health Authority that part-funded development of the community participation method, through the original project, had not adopted the new method. Community members tended to attribute lack of further impact to low participation and methods insufficiently attuned to the social nuances of very small rural communities. Managers tended to blame insufficient embedding in the healthcare system and issues around power over service change and budgets. In the absence of convincing formal community governance mechanisms for health issues, rural health practitioners tended to act as conduits between citizens and the Health Authority. The study provides new knowledge about what happens after community participation and highlights a need for more exploration. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Studying Leadership within Successful Rural Communities in a Southeastern State: A Qualitative Analysis

    Science.gov (United States)

    Ricketts, Kristina G.

    2009-01-01

    Many rural communities are experiencing a diversity of issues, but what part does leadership play in these communities? This qualitative study describes the environment within two communities in the southeast focusing on community variables of psychological sense of community, community leadership, and social capital. Leaders were identified and a…

  11. Reforming Victoria's primary health and community service sector: rural implications.

    Science.gov (United States)

    Alford, K

    2000-01-01

    In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.

  12. History, culture, and substance use in a rural Scottish community.

    Science.gov (United States)

    Dean, Alan

    2002-01-01

    This paper provides a detailed discussion of substance use and misuse in a rural community in the Western Highlands of Scotland, United Kingdom. Attention is focused on the way in which patterns of substance use arise from a complex interplay of historical, cultural, social, and personal events. The discussion illustrates how large changes in patterns of intoxication in rural communities can be rendered intelligible through an understanding of the impact of economic, religious, and social changes. The analysis is based on an historical and ethnographic account, carried out between 1987 and 1990 with adolescents, of patterns of use which range from pagan ceremonies in the 16th century to contemporary "soft drug" use.

  13. Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities.

    Science.gov (United States)

    Rayens, Mary Kay; Butler, Karen M; Wiggins, Amanda T; Kostygina, Ganna; Langley, Ronald E; Hahn, Ellen J

    2016-05-01

    Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing: gain-framed messages (ie, benefits of smoke-free environments) to

  14. Community Strategic Visioning as a Method to Define and Address Poverty: An Analysis from Select Rural Montana Communities

    Science.gov (United States)

    Lachapelle, Paul; Austin, Eric; Clark, Daniel

    2010-01-01

    Community strategic visioning is a citizen-based planning process in which diverse sectors of a community collectively determine a future state and coordinate a plan of action. Twenty-one communities in rural Montana participated in a multi-phase poverty reduction program that culminated in a community strategic vision process. Research on this…

  15. 'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

    Science.gov (United States)

    Kostygina, Ganna; Hahn, Ellen J; Rayens, Mary Kay

    2014-02-01

    Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities.

  16. Rural Revitalization in New Mexico: A Grass Roots Initiative Involving School and Community

    Science.gov (United States)

    Pitzel, Gerald R.; Benavidez, Alicia C.; Bianchi, Barbara C.; Croom, Linda L.; de la Riva, Brandy R.; Grein, Donna L.; Holloway, James E.; Rendon, Andrew T.

    2007-01-01

    The Rural Education Bureau of the New Mexico Public Education Department has established a program to address the special needs of schools and communities in the extensive rural areas of the state. High poverty rates, depopulation and a general lack of viable economic opportunity have marked rural New Mexico for decades. The program underway aims…

  17. Policy Change and Its Effect on Australian Community-Based Natural Resource Management Practices

    Science.gov (United States)

    Cooke, Penelope R.; Hemmings, Brian C.

    2016-01-01

    The authors of this article report on a qualitative study of Australian community-based natural resource management groups known as Landcare groups. They discuss how four Landcare groups contributed to sustainability practices and how a policy change implemented in 2003 influenced the efforts of the groups to remain active in their activities.…

  18. The role and organisation of community palliative specialist nursing teams in rural England.

    Science.gov (United States)

    Leadbeater, Maria; Staton, Wendy

    2014-11-01

    This article describes a study that used a qualitative approach, purposive sampling and semi-structured telephone interviews conducted with specialist palliative care nurses from six rural community teams in England. The study investigated how services were organised and the issues of delivering specialist palliative nursing care in a rural area. Qualitative content analysis was used to analyse the data. The findings showed many similarities in that the majority of patients in rural areas were not accessing hospice services and there was a greater reliance on care at home. However, the challenges in delivering care ranged from managing patient expectations, geographical distance, lack of technology to support remote working and education for the specialist palliative care teams. The study makes specific recommendations for rural community specialist palliative care teams.

  19. -And twelve months later, we are still waiting-: Insights into teaching and use of ICT in rural and remote Australian schools

    Directory of Open Access Journals (Sweden)

    Neil Anderson

    2007-12-01

    Full Text Available This paper presents an analysis of the combined data sets from a large ARC (Australian Research Council funded study on the declining enrolments of female students in high school information technology subjects, and a SiMERR (Science, ICT and Mathematics Education for Rural and Regional Australia study of 9 rural or remote schools in the state of Queensland. The aim of examining the combined data set was to investigate any apparent differences between girls’ perceptions of studying higher level ICT subjects in rural areas compared to metropolitan areas. The findings of the study highlighted some problems experienced by female students studying outside of metropolitan areas. They perceived the subject offerings to be ‘more boring’ than their city counterparts and reported a lower level of home ownership. The paper offers possible explanations for the findings and strongly recommends that strategies need to be implemented to overcome these problems.

  20. Proposing a health promotion framework to address gambling problems in Australian Indigenous communities.

    Science.gov (United States)

    Fogarty, Marisa; Coalter, Nicola; Gordon, Ashley; Breen, Helen

    2018-02-01

    Gambling impacts affect Australian Indigenous families and communities in diverse and complex ways. Indigenous people throughout Australia engage in a broad range of regulated and unregulated gambling activities. Challenges in this area include the complexities that come with delivering services and programmes between the most remote regions, to highly populated towns and cities of Australia. There is little knowledge transfer between states and territories in Australia and no conceptual understanding or analysis of what constitutes 'best practice' in gambling service delivery for Indigenous people, families and communities. This article reviews health promotion approaches used in Australia, with a particular focus on Indigenous and gambling-based initiatives. Contributing to this review is an examination of health promotion strategies used in Indigenous gambling service delivery in the Northern Territory, New South Wales and Western Australia, demonstrating diversity and innovation in approaches. The article concludes by emphasizing the potential value of adopting health promotion strategies to underpin programme and service delivery for addressing gambling problems in Australian Indigenous communities. However, success is contingent on robust, evidence-based programme design, implementation and evaluation that adhere to health promotion principles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Uses, benefits and challenges of using rural community telecentres ...

    African Journals Online (AJOL)

    Levi Manda

    train staff in customer care. Key words: ... Telecentres also provide space for rural community members to .... card reader and a receipt printer to a full service telecentre that offers ... telecentres is a good development since telecentres target the.

  2. Community Interactive Processes and Rural Adolescents’ Educational Achievement: Investigating the Mediating Effects of Delinquency and Self-Esteem

    Directory of Open Access Journals (Sweden)

    Omolola A. Adedokun

    2008-09-01

    Full Text Available The study reported in this paper examines the effects of community interactive processes on rural adolescents’ educational achievement. Specifically, the paper explored the direct effects of community interactive processes on rural adolescents’ educational achievement and the indirect effects via self-esteem and delinquency. The method of structural equation modeling was used to analyze data from a nationally representative panel study of rural adolescent boys and girls in 10th grade through 12th grade. The results make a compelling case that communities are conduits for boosting self-esteem, facilitating normative behaviors and academic performance in rural adolescents.

  3. Evolutionary Approach of Virtual Communities of Practice: A Reflection within a Network of Spanish Rural Schools

    Science.gov (United States)

    Frossard, Frédérique; Trifonova, Anna; Barajas Frutos, Mario

    The isolation of rural communities creates special necessities for teachers and students in rural schools. The present article describes "Rural Virtual School", a Virtual Community of Practice (VCoP) in which Spanish teachers of rural schools share learning resources and teaching methodologies through social software applications. The article arrives to an evolutionary model, in which the use of the social software tools evolves together with the needs and the activities of the VCoP through the different stages of its lifetime. Currently, the community has reached a high level of maturity and, in order to keep its momentum, the members intentionally use appropriate technologies specially designed to enhance rich innovative educational approaches, through which they collaboratively generate creative practices.

  4. Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study.

    Science.gov (United States)

    Hayter, Arabella K M; Jeffery, Roger; Sharma, Chitra; Prost, Audrey; Kinra, Sanjay

    2015-01-01

    Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. We undertook a qualitative study consisting of nine focus group discussions (FGDs) (n=57) in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases), with the aim of defining future interventions. The transcripts were analysed thematically. Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years.

  5. Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos

    Directory of Open Access Journals (Sweden)

    Eugene Aisenberg

    2012-01-01

    Full Text Available Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.

  6. Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples.

    Science.gov (United States)

    Smith, Tina Anderson; Adimu, Tanisa Foxworth; Martinez, Amanda Phillips; Minyard, Karen

    2016-01-01

    This paper explores how communities translate evidence-based and promising health practices to rural contexts. A descriptive, qualitative analysis was conducted using data from 70 grantees funded by the Federal Office of Rural Health Policy to implement evidence-based health practices in rural settings. Findings were organized using The Interactive Systems Framework for Dissemination and Implementation. Grantees broadly interpreted evidence-based and promising practices, resulting in the implementation of a patchwork of health-related interventions that fell along a spectrum of evidentiary rigor. The cohort faced common challenges translating recognized practices into rural community settings and reported making deliberate modifications to original models as a result. Opportunities for building a more robust rural health evidence base include investments to incentivize evidence-based programming in rural settings; rural-specific research and theory-building; translation of existing evidence using a rural lens; technical assistance to support rural innovation; and prioritization of evaluation locally.

  7. Preferred practice location at medical school commencement strongly determines graduates' rural preferences and work locations.

    Science.gov (United States)

    Herd, Marie S; Bulsara, Max K; Jones, Michael P; Mak, Donna B

    2017-02-01

    To identify factors influencing whether Australian medical graduates prefer to, or actually, work rurally. Secondary analysis of longitudinal data from Medical Schools Outcomes Database (MSOD) using univariate and multivariate logistic regression. Twenty Australian medical schools. Australian or New Zealand citizens and Australian permanent residents who completed MSOD questionnaires between 2006 and 2013. Preferred and actual work locations 1 (PGY1) and 3 (PGY3) years postgraduation. Of 20 784 participants, 4028 completed a PGY1 or PGY3 questionnaire. Self-reported preference for rural practice location at medical school commencement was the most consistent independent predictor of whether a graduate would have a rural location preference at PGY1 (odds ratio (OR) 6.07, 95% confidence interval (CI) 4.91-7.51) and PGY3 (OR 7.95, 95% CI 4.93-12.84), and work rurally during PGY1 (OR 1.38, 95% CI 1.01-1.88) and PGY3 (OR 1.86, 95% CI 1.30-2.64). The effect of preferred practice location at medical school commencement is independent of, and enhances the effect of, rural background. Graduates of graduate-entry programs or with dependent children were less likely to have worked rurally during PGY1 and PGY3 respectively. The most consistent factor associated with rural preferences and work location was students' preferred location of practice at medical school commencement; this association is independent of, and enhances the effect of, rural background. Better understanding of what determines rural preference at medical school commencement and its influence on rural workplace outcomes beyond PGY3 is required to inform Australian medical school selection policies and rural health curricula. © 2016 National Rural Health Alliance Inc.

  8. Nurses who work in rural and remote communities in Canada: a national survey.

    Science.gov (United States)

    MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela

    2017-05-23

    In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote

  9. Predictors of dental visits among primary school children in the rural Australian community of Lithgow.

    Science.gov (United States)

    John, James Rufus; Mannan, Haider; Nargundkar, Subrat; D'Souza, Mario; Do, Loc Giang; Arora, Amit

    2017-04-11

    Regular dental attendance is significant in maintaining and improving children's oral health and well-being. This study aims to determine the factors that predict and influence dental visits in primary school children residing in the rural community of Lithgow, New South Wales (NSW), Australia. All six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementing water fluoridation in 2014. Children aged 6-13 years (n = 667) were clinically examined for their oral health status and parents were requested to complete a questionnaire on fluoride history, diet, last dental visit, and socio-demographic characteristics. Multiple logistic regression analyses were employed to examine the independent predictors of a 6-monthly and a yearly dental visit. Overall, 53% of children visited a dentist within six months and 77% within twelve months. In multiple logistic regression analyses, age of the child and private health insurance coverage were significantly associated with both 6-monthly and twelve-month dental visits. In addition, each serve of chocolate consumption was significantly associated with a 27% higher odds (OR = 1.27, 95% CI: 1.05-1.54) of a 6-monthly dental visit. It is imperative that the socio-demographic and dietary factors that influence child oral health must be effectively addressed when developing the oral health promotion policies to ensure better oral health outcomes.

  10. ‘It’s about the smoke, not the smoker’: messages that motivate rural communities to support smoke-free policies

    OpenAIRE

    Kostygina, Ganna; Hahn, Ellen J.; Rayens, Mary Kay

    2013-01-01

    Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were...

  11. An evaluation of a community pharmacy-based rural asthma management service.

    Science.gov (United States)

    Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol

    2008-04-01

    To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.

  12. Distance is no hurdle: Reforming the family violence exception to better protect immigrant women in rural, regional and remote communities

    Directory of Open Access Journals (Sweden)

    Khanh Hoang

    2015-01-01

    Full Text Available After careful consideration consistent with COPE guidelines, the editorial staff has concluded that there is no case of plagiarism associated with this article. (10th August, 2016 The editors have received allegations that the paper references arguments and evidence without attribution to pre-existing literature, and that it exhibits stylistic similarities to other sources on the same topic. The editors are currently conducting an investigation under the Committee on Publication Ethics (COPE guidelines to confirm or refute the allegations. (29th June, 2016 This article considers the impact of migration laws on immigrant women in rural, regional and remote communities (RRR communities who are victims of family violence. The Migration Regulations 1994 (Cth (‘the Regulations’ includes a ‘family violence exception’ that allows for the grant of permanent residency to women who hold a temporary partner visa in circumstances where the relationship with the Australian sponsor has broken down due to family violence. However, the Regulations impose strict procedural and evidentiary requirements for making a family violence claim. These laws disproportionately impact those in RRR communities by failing to account for their isolation, lack of access to services and particular vulnerabilities. As a result, immigrant women in RRR communities are restricted in their ability to access the family violence exception. This article calls for reform of the Regulations to address the locational disadvantages faced by immigrant women in RRR communities. Building on the work of the Australian Law Reform Commission, it argues for the repeal of the provisions governing evidentiary requirements for ‘non-judicially determined’ claims of family violence. In its place, it is suggested that there should be no restrictions on the types of evidence that can be provided. In addition, all non-judicially determined family violence claims would be referred to an

  13. Participatory Design to Enhance ICT Learning and Community Attachment: A Case Study in Rural Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Ting Huang

    2015-03-01

    Full Text Available This study used observation and interviews with participants in “PunCar Action” to understand how participatory design methods can be applied to the education of rural individuals in information and communication technology (ICT. PunCar Action is a volunteer program in which ICT educators tour the rural communities of Taiwan, offering courses on the use of digital technology. This paper makes three contributions: First, we found that participatory design is an excellent way to teach ICT and Web 2.0 skills, co-create community blogs, and sustain intrinsic motivation to use Web applications. Second, PunCar Action provides an innovative bottom-up intergenerational ICT education model with high penetrability capable of enhancing the confidence of rural residents in the use of ICT. Third, the content of basic courses was based on applications capable of making the lives of elderly individuals more convenient, and the advanced course was based on the co-creation of community blogs aimed at reviving the core functions of communities and expanding local industry. Our research was conducted with the use of a non-quantitative index to measure ICT learning performance of participants from a rural community. The results show that PunCar Action emphasizes interpersonal communication and informational applications and creates a collaborative process that encourages rural residents to take action to close the digital divide.

  14. Cultural context of school communities in rural Hawaii to inform youth violence prevention.

    Science.gov (United States)

    Affonso, Dyanne D; Mayberry, Linda; Shibuya, June Y; Archambeau, Olga G; Correa, Mary; Deliramich, Aimee N; Frueh, B Christopher

    2010-03-01

    Escalation of youth violence within a large geographic school-complex area in southeastern rural Hawaii became a major problem in 2006. How cultural forces impact the problem was an impetus to examine youth violence from perspectives of adults and children in rural communities. Gathering these data was an essential first step toward school-based youth violence prevention program development. Eight focus groups involving 86 community stakeholders included 51 adults (parent, teachers, school staff, community leaders) and 35 children aged 8-15 years old (3rd- to 10-th grade). Qualitative narrative analysis elicited major themes. Five themes emerged: (1) School-community violence takes on many forms that become entrenched in local culture. (2) Disintegration of community resources and a sense of learned helplessness underlie the escalation of youth violence. (3) Inadequate role modeling coupled with behavioral ambivalence among adults has sustained a climate of local cultural acceptance with youth violence. (4) Connection to cultural values has diminished, leading to a sense of loss in cultural identity among students. (5) Cultural values and practices are potential strategies for youth violence prevention. Cultural and community contextual factors contributed to youth violence in rural Hawaiian communities. Study implications include the need to further investigate the impact of vigilant, community involvement of stakeholders in school-based youth violence prevention program development. Cultural revitalization at family, school, and community levels may be critical success factors of such programs.

  15. Archaeological Excavation and Deep Mapping in Historic Rural Communities

    Directory of Open Access Journals (Sweden)

    Carenza Lewis

    2015-09-01

    Full Text Available This paper reviews the results of more than a hundred small archaeological “test pit” excavations carried out in 2013 within four rural communities in eastern England. Each excavation used standardized protocols in a different location within the host village, with the finds dated and mapped to create a series of maps spanning more than 3500 years, in order to advance understanding of the spatial development of settlements and landscapes over time. The excavations were all carried out by local volunteers working physically within their own communities, supported and advised by professional archaeologists, with most test pits sited in volunteers’ own gardens or those of their friends, family or neighbors. Site-by-site, the results provided glimpses of the use made by humans of each of the excavated sites spanning prehistory to the present day; while in aggregate the mapped data show how settlement and land-use developed and changed over time. Feedback from participants also demonstrates the diverse positive impacts the project had on individuals and communities. The results are presented and reviewed here in order to highlight the contribution archaeological test pit excavation can make to deep mapping, and the contribution that deep mapping can make to rural communities.

  16. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Science.gov (United States)

    Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

    2016-01-01

    Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality

  17. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Blessing U. Mberu

    2016-12-01

    Full Text Available Background: It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective: The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design: We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results: In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to

  18. Role of community pharmacists in asthma - Australian research highlighting pathways for future primary care models.

    Science.gov (United States)

    Saini, B; Krass, I; Smith, L; Bosnic-Anticevich, S; Armour, C

    2011-01-01

    Asthma is one of the most common chronic conditions affecting the Australian population. Amongst primary healthcare professionals, pharmacists are the most accessible and this places pharmacists in an excellent position to play a role in the management of asthma. Globally, trials of many community pharmacy-based asthma care models have provided evidence that pharmacist delivered interventions can improve clinical, humanistic and economic outcomes for asthma patients. In Australia, a decade of coordinated research efforts, in various aspects of asthma care, has culminated in the implementation trial of the Pharmacy Asthma Management Service (PAMS), a comprehensive disease management model.There has been research investigating asthma medication adherence through data mining, ways in which usual asthma care can be improved. Our research has focused on self-management education, inhaler technique interventions, spirometry trials, interprofessional models of care, and regional trials addressing the particular needs of rural communities. We have determined that inhaler technique education is a necessity and should be repeated if correct technique is to be maintained. We have identified this effectiveness of health promotion and health education, conducted within and outside the confines of the pharmacy, in public for a and settings such as schools, and established that this outreach role is particularly well received and increases the opportunity for people with asthma to engage in their asthma management.Our research has identified that asthma patients have needs which pharmacists delivering specialized models of care, can address. There is a lot of evidence for the effectiveness of asthma care by pharmacists, the future must involve integration of this role into primary care.

  19. Counselors and Special Educators in Rural Schools Working Together to Create a Positive School Community

    Science.gov (United States)

    Thornton, Frank

    2018-01-01

    School counselors and special educators in rural areas working together can be a powerful team to help schools create a positive school community. In one rural school community, they partnered with faculty and staff to implement a School Wide Positive Behavior support program to improve student outcomes. The counselor and special educator, through…

  20. Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study.

    Science.gov (United States)

    Walker, Judith H; Dewitt, Dawn E; Pallant, Julie F; Cunningham, Christine E

    2012-01-01

    Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (ppreferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice

  1. The important role of springs in South Africa's rural water supply: The case study of two rural communities in South Africa

    CSIR Research Space (South Africa)

    Nkuna, Z

    2014-12-01

    Full Text Available rural communities are geographically located in hard to reach areas due to their dispersed nature and bad terrain. In South Africa, these conditions have made it particularly expensive and difficult for water service providers to effect services to rural...

  2. What are Pregnant Women in a Rural Niger Delta Community's ...

    African Journals Online (AJOL)

    Erah

    Buchanan House, Glasgow Caledonian University Email: Caroline. ... exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's perceptions of ..... sometimes you stay for the whole day.

  3. Malaria parasitaemia among pregnant women in a rural community ...

    African Journals Online (AJOL)

    Malaria parasitaemia among pregnant women in a rural community of ... ours, it is a common cause of anaemia in pregnancy in both immune and non-immune ... Apart from the use of nets, drugs and vector control, the prevention of malaria in ...

  4. The Biofuels Revolution: Understanding the Social, Cultural and Economic Impacts of Biofuels Development on Rural Communities

    Energy Technology Data Exchange (ETDEWEB)

    Selfa, Theresa L; Goe, Richard; Kulcsar, Laszlo; Middendorf, Gerad; Bain, Carmen

    2013-02-11

    The aim of this research was an in-depth analysis of the impacts of biofuels industry and ethanol plants on six rural communities in the Midwestern states of Kansas and Iowa. The goal was to provide a better understanding of the social, cultural, and economic implications of biofuels development, and to contribute to more informed policy development regarding bioenergy.Specific project objectives were: 1. To understand how the growth of biofuel production has affected and will affect Midwestern farmers and rural communities in terms of economic, demographic, and socio-cultural impacts; 2. To determine how state agencies, groundwater management districts, local governments and policy makers evaluate or manage bioenergy development in relation to competing demands for economic growth, diminishing water resources, and social considerations; 3. To determine the factors that influence the water management practices of agricultural producers in Kansas and Iowa (e.g. geographic setting, water management institutions, competing water-use demands as well as producers attitudes, beliefs, and values) and how these influences relate to bioenergy feedstock production and biofuel processing; 4. To determine the relative importance of social-cultural, environmental and/or economic factors in the promotion of biofuels development and expansion in rural communities; The research objectives were met through the completion of six detailed case studies of rural communities that are current or planned locations for ethanol biorefineries. Of the six case studies, two will be conducted on rural communities in Iowa and four will be conducted on rural communities in Kansas. A multi-method or mixed method research methodology was employed for each case study.

  5. The development of a caseload midwifery service in rural Australia.

    Science.gov (United States)

    Tran, Tara; Longman, Jo; Kornelsen, Jude; Barclay, Lesley

    2017-08-01

    The past two decades have seen progressive decline in the number of rural birthing services across Australia. Despite health system pressures on small birthing units to close there have been examples of resistance and survival. This descriptive study explored the evolution of a rural birthing service in a small town to offer insight into the process of transition which may be helpful to other small healthcare services in rural Australia. Quantitative data derived from birth registers on number and types of birth from 1993-2011 were analysed. Interviews were conducted between January and August 2012 with nine participants (GP obstetricians, midwives, a health service manager and a consumer representative). This rural maternity service developed gradually from a GP obstetrician-led service to a collaborative care team approach with midwifery leadership. This development was in response to a changing rural medical workforce, midwifery capacity and the needs and wants of women in the local community. Four major themes were developed from interview data: (1) development of the service (2) drivers of change (3) outcomes and (4) collaborative care and inter-professional practice. The success of this transition was reported to rest on strategic planning and implementation and respectful inter-professional practice and alignment of birth philosophy across the team. This team created a unified, progressive community-focused birthing service. The development of collaborative care models that embrace and build on established inter-professional relationships can maximise existing rural workforce potential and create a sustainable rural service into the future. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Utilising a collective case study system theory mixed methods approach: a rural health example.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2014-07-28

    Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services

  7. Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men: a study protocol

    Directory of Open Access Journals (Sweden)

    Ricciardelli Lina A

    2012-01-01

    Full Text Available Abstract Background Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. Methods and design The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. Discussion This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in

  8. the impact of community participation in rural water management in

    African Journals Online (AJOL)

    USER

    2016-04-14

    Apr 14, 2016 ... underdeveloped areas with poor water resources. ... rural water management is purportedly a key element for community water pro ects to ..... inclusive and integrated approach to water ... Implementation: A regional response.

  9. The Politics of the MST Autonomous Rural Communities, the State, and Electoral Politics

    NARCIS (Netherlands)

    Vergara Camus, Leandro

    Examination of the politicization of landless people in the encampments and settlements of the Movimento dos Trabalhadores Rurais Sem-Terra (Landless Rural Workers' Movement-MST) in Brazil suggests that the movement's success rest on the fact that it generates relatively autonomous rural communities

  10. The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria.

    Science.gov (United States)

    Isara, Alphonsus Rukevwe; Okundia, Patrick Otamere

    2015-01-01

    The African region of the world is experiencing a double epidemic of both communicable and non-communicable diseases. The objective of the study was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria. A community based descriptive cross-sectional study. Adults aged 18 years and above residing in the rural communities who attended a free medical outreach programme were screened for hypertension and diabetes mellitus. Data were collected using a structured interviewer-administered questionnaire. Of the 845 participants, 349 (41.3%) were aged 50-69 years, 263 (31.1%) were males, and 305 (36.1%) were farmers. Overweight and obesity were found in 184 (21.8%) and 90 (10.6%) of them respectively. The overall prevalence of hypertension was 37.6% (males 43.7%, females 35.1%, p = 0.018) while that of diabetes mellitus was 4.6% (males 1.9%, females 5.8%, p = 0.012). Predictors of hypertension were age ≥ 40 years (OR = 5.04, CI: 2.99 - 8.48), overweight/obesity (OR = 1.56, CI: 1.15 - 2.13) while females are less likely to develop hypertension (OR = 0.72, CI: 0.53 - 0.98). The significant predictor of diabetes mellitus was overweight/obesity (OR = 3.53, CI: 1.78 - 6.98). The rising prevalence of hypertension and diabetes mellitus is assuming an epidemic level in rural communities in southern Nigeria. There is an urgent need for intensive health education and community surveillance programmes targeted at rural communities in order to achieve prevention and control of these non-communicable diseases in Nigeria.

  11. Prevalence of congenital heart disease in rural communities of pakistan

    International Nuclear Information System (INIS)

    Rizvi, S.F.U.; Mustafa, G.; Khan, M.A.; Kundi, A.

    2015-01-01

    Prevalence of congenital heart disease (CHD) is well established in most of the developed countries, where childbirth is obligatory in hospital and allied facilities. In rural Pakistan the situation is reverse, where most of deliveries take place in homes by traditional birth attendants' therefor true prevalence of CHD in our population is unknown. in rural Pakistan almost 80% children are born at home hence the figures are unknown. This study was designed, to determine the prevalence of congenital heart disease in rural Pakistan. Methods: During a cross-sectional survey of rural population belonging to major ethnic groups living in three provinces of Pakistan to determine the prevalence of rheumatic heart disease (RHD), CHD rates were calculated as a sub study. Nine thousand four hundred and seventy-six (9476) subjects of all ages were screened using cluster sampling technique. Socio-demographic variables were recorded. Auscultation and short physical examination performed for initial screening and final diagnosis was confirmed on M-mode/2D/Doppler. Results: Thirty two patients had RHD, 25 Patients identified with CHD and another 7 patients had mixed CHD and RHD. Overall prevalence for CHD was 3.4/1000. The commonest lesion was Atrial Septal Defect (ASD) 40%, Ventricular Septal Defect (VSD) 35%, Aortic Stenosis (AS) 10%, Atrio Ventricular Septal Defect (AVSD) 5%. Conclusion: This is the first study to report CHD prevalence from multiethnic representative sample from rural communities of Pakistan. Apparently CHD rate seems less compared with facility based data because records of still stillbirths are not available and autopsies are not performed as routine. Very high infant mortality from rural areas of Pakistan also favours high prevalence for CHD; however these figures represent an overall picture of CHD in a community where medical facilities are lacking. (author)

  12. The Role of Community Based Orgs (Cbos) In Rural and Agricultural ...

    African Journals Online (AJOL)

    The result showed that community based organizations are veritable agents of development in ensuring the agricultural and rural transformation of Delta State. The study recommended that there is need to develop a link between the state and community us so as to increase the managerial and professional capabilities of ...

  13. Red Dirt Thinking on Child Wellbeing in Indigenous, Rural and Remote Australian Communities: The SpICE Model "I Just Don't Want my Kid to Struggle Like I Did at School"

    Science.gov (United States)

    Clarke, Kendall; Denton, Marijke

    2013-01-01

    Supporting children in their early development and learning has long-term benefits for both them and the broader community. Yet in Australia we still have significant examples of inequality of opportunity (Allan, 2010) and other structural barriers to family wellbeing, particularly in Indigenous and rural and remote communities (Bourke, Humphreys,…

  14. [Food insecurity in rural communities in Northeast Brazil: does belonging to a slave-descendent community make a difference?

    Science.gov (United States)

    Silva, Etna Kaliane Pereira da; Medeiros, Danielle Souto de; Martins, Poliana Cardoso; Sousa, Líllian de Almeida; Lima, Gislane Pereira; Rêgo, Maria Amanda Sousa; Silva, Tainan Oliveira da; Freire, Alessandra Silva; Silva, Fernanda Moitinho

    2017-06-01

    This study aimed to measure the prevalence of food insecurity in a rural area of Northeast Brazil and investigate this outcome according to residence in quilombola communities (descendants of African slaves) versus non-quilombola communities. This was a cross-sectional study in 21 rural communities, 9 of which quilombolas, in 2014, using the Brazilian Food Insecurity Scale (EBIA). Prevalence rates and prevalence ratios were estimated for food insecurity, and Poisson multiple regression analysis with robust variance was performed. Food insecurity was found in 52.1% of the families: 64.9% in quilombola communities and 42% in the others. Food insecurity was associated with belonging to a quilombola community (PR = 1.25), lower economic status (PR = 1.89; 2.98, and 3.22 for status C2, D, and E, respectively), beneficiaries of Bolsa Família program (PR = 1.52), and four or more household members (PR = 1.20). Food insecurity prevalence was high in the entire population, but it was even higher in quilombola communities, even though they belonged to the same coverage area. The results emphasize this population's vulnerability.

  15. Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

    Science.gov (United States)

    Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

    2014-01-01

    Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve

  16. Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians.

    Science.gov (United States)

    West, Matthew; Chuter, Vivienne; Munteanu, Shannon; Hawke, Fiona

    2017-01-01

    The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91%) while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Aboriginal and Torres Strait Islander Australians have a 3-6 fold increased likelihood of experiencing a

  17. Australia's rural medical workforce: Supply from its medical schools against career stage, gender and rural-origin.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J

    2017-10-01

    The aim of this study was to explore the association between career stage and rural medical workforce supply among Australian-trained medical graduates. Descriptive analysis using the national Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal study. Australian-trained GPs and other specialists who participated in the MABEL study, 2008-2013. Proportions of GPs and specialists working in rural locations, according to career stage (establishing, early, mid and late), gender and childhood-origin type (rural versus metropolitan). Logistic regression models revealed that establishing- and early-career GPs had significantly higher likelihood (OR 1.67 and 1.38, respectively) of working rurally, but establishing and early-career doctors were significantly less likely (OR 0.34 and 0.43, respectively) to choose general practice, contributing proportionally fewer rural GPs overall (OR 0.77 and 0.75, respectively) compared to late-career doctors. For specialists, there were no significant associations between career cohorts and rural practice. Overall, there was a significantly lower likelihood (OR 0.83) of establishing-career doctors practising rurally. Women were similarly likely to be rural GPs but less likely to be rural specialists, while rural-origin was consistently associated with higher odds of rural practice. The supply of Australia's rural medical workforce from its medical schools continues to be challenging, with these data highlighting both their source and associations with doctors at different career stages. Despite large investments through rural medical training and rural workforce recruitment and retention policies, these data confirm continued reliance on internationally trained medical graduates for large proportions of rural supply is likely. © 2016 National Rural Health Alliance Inc.

  18. General surgery graduates may be ill prepared to enter rural or community surgical practice.

    Science.gov (United States)

    Gillman, Lawrence M; Vergis, Ashley

    2013-06-01

    Rural/community surgery presents unique challenges to general surgeons. Not only are they required to perform "classic" general surgery procedures, but they are also often expected to be competent in other surgical disciplines. Final-year Canadian-trained residents in general surgery were asked to complete the survey. The survey explored chief residents' career plans for the following year and whether or not they would independently perform various procedures, some general surgical, and others now considered within the domain of the subspecialties. Sixty-four residents (71%) completed the survey. Twenty percent planned to undertake a rural surgical practice, 17% an urban community practice, and 55% had confirmed fellowships. Most residents (>90%) expressed comfort with basic general surgical procedures. However, residents were less comfortable with subspecialty procedures that are still performed by general surgeons in many rural practices. More than half of graduating general surgery residents are choosing subspecialty fellowship training over proceeding directly to practice. Those choosing a rural or community practice are likely to feel ill prepared to replace existing surgeons. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. The Influence of Age and Gender on Skin-Associated Microbial Communities in Urban and Rural Human Populations.

    Directory of Open Access Journals (Sweden)

    Shi Ying

    Full Text Available Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urban or rural environment, with a significantly greater relative abundance of Trabulsiella in urban populations. Adults maintained greater overall microbial diversity than adolescents or the elderly, while the intragroup variation among the elderly and rural populations was significantly greater. Skin-associated bacterial community structure and composition could predict whether a sample came from an urban or a rural resident ~5x greater than random.

  20. Australian Football League concussion guidelines: what do community players think?

    Science.gov (United States)

    White, Peta E; Donaldson, Alex; Sullivan, S John; Newton, Joshua

    2016-01-01

    Background Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players’ views on following the Australian Football League's (AFL) concussion guidelines. Methods 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently. Results Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players’ rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players’ desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost. Conclusions Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport. PMID:28890801

  1. Perceptions of Students at a Rural Mississippi Community College Regarding Employability

    Science.gov (United States)

    Harrris, Cortney R.

    2013-01-01

    Research studies show that there is a skills gap in American society today. This research study examined employability perceptions of community college students at a rural community college in Mississippi. Students were asked to complete an online survey that questioned the degree of importance placed on several employability skills, as well as…

  2. Understanding food security issues in remote Western Australian Indigenous communities.

    Science.gov (United States)

    Pollard, Christina M; Nyaradi, Anett; Lester, Matthew; Sauer, Kay

    2014-08-01

    Food insecurity in remote Western Australian (WA) Indigenous communities. This study explored remote community store managers' views on issues related to improving food security in order to inform health policy. A census of all remote WA Indigenous community store managers was conducted in 2010. Telephone interviews sought managers' perceptions of community food insecurity, problems with their store, and potential policy options for improving the supply, accessibility, affordability and consumption of nutritious foods. Descriptive analyses were conducted using SPSS for Windows version 17.0. Managers stated that freight costs and irregular deliveries contributed to high prices and a limited range of foods. Poor store infrastructure, compromised cold chain logistics, and commonly occurring power outages affected food quality. Half of the managers said there was hunger in their community because people did not have enough money to buy food. The role of nutritionists beyond a clinical and educational role was not understood. Food security interventions in remote communities need to take into consideration issues such as freight costs, transport and low demand for nutritious foods. Store managers provide important local knowledge regarding the development and implementation of food security interventions. SO WHAT? Agencies acting to address the issue of food insecurity in remote WA Indigenous communities should heed the advice of community store managers that high food prices, poor quality and limited availability are mainly due to transport inefficiencies and freight costs. Improving healthy food affordability in communities where high unemployment and low household income abound is fundamental to improving food security, yet presents a significant challenge.

  3. 'Although we're isolated, we're not really isolated': The value of information and communication technology for older people in rural Australia.

    Science.gov (United States)

    Berg, Turi; Winterton, Rachel; Petersen, Maree; Warburton, Jeni

    2017-12-01

    Drawing from a larger study that identified the supports and services that facilitate wellness among older people from rural communities, this study examined the specific contribution made by information and communication technology (ICT). Qualitative interviews were undertaken with 60 older adults from six Australian rural areas. A preliminary thematic analysis was conducted, followed by a higher-order inductive analysis. Information and communication technology use was discussed in terms of individual enrichment, and in terms of enabling connections between the individual and their social networks, community and wider service environments. Information and communication technologies may facilitate wellness for rural older people by compensating for geographical and social isolation. In the changing world of health and aged care service delivery, ICTs will be more important than ever for rural older people in building their capacity to access the services, socialisation and support that they need, regardless of location. © 2017 AJA Inc.

  4. 77 FR 65547 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2012-10-29

    ... programs that affect and engage agriculture and rural communities. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, U.S. EPA, Office of the Administrator (1101A), 1200 Pennsylvania Avenue NW., Washington, DC 20460. Dated: October 17, 2012. Alicia...

  5. The Implementation of TTG Book Service Done By Community Library in Rural Area

    Directory of Open Access Journals (Sweden)

    Pawit Muhammad Yusup

    2016-06-01

    Full Text Available The problem of poverty in rural areas cannot be separated from the following aspects: poverty, lack of education facilities, low level of entrepreneurial skills, health, lack of learning facilities, population distribution, infrastructure and facilities are inadequate, access to information, and other aspects that are still limited. The Village Library and Community Library as part of the affordable infrastructure and learning facilities are, not yet available in every village. This study tried to introduce pilot models Appropriate Technology Implementation Services Book through Rural Libraries and the community library to a number of poor people in the village. The result could contribute in improving the skills of a number of rural poor in entrepreneurship-based reading. This service models can be applied in other similar villages.

  6. Investigating the Factors of Resiliency among Exceptional Youth Living in Rural Underserved Communities

    Science.gov (United States)

    Curtin, Kevin A.; Schweitzer, Ashley; Tuxbury, Kristen; D'Aoust, Janelle A.

    2016-01-01

    Resilience is an important social justice concept that has important implications for educators working with exceptional youth in rural underserved communities who may suffer from the consequences associated with economic hardships. This multi-school qualitative study examined resilience among exceptional youth living in rural poverty through the…

  7. Screening mammography uptake within Australia and Scotland in rural and urban populations.

    Science.gov (United States)

    Leung, Janni; Macleod, Catriona; McLaughlin, Deirdre; Woods, Laura M; Henderson, Robert; Watson, Angus; Kyle, Richard G; Hubbard, Gill; Mullen, Russell; Atherton, Iain

    2015-01-01

    To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography.

  8. Needs of Aboriginal and Torres Strait Islander clients residing in Australian residential aged-care facilities.

    Science.gov (United States)

    Brooke, Nicole J

    2011-08-01

    This review was undertaken to identify evidence-based practice guidelines to support the care needs of Aboriginal and Torres Strait Islander clients residing in residential aged-care facilities. A systematic literature review was undertaken. An electronic search of online databases and subsequent manual retrieval process was undertaken to identify relevant reports and studies that explored interventions for care of an Aboriginal and Torres Strait Islander person. Very limited published material identified strategies necessary within residential aged care. Sixty-seven articles were considered for inclusion, and a subsequent review resulted in 34 being included due to direct alignment with the study aim. Strategies recommended within the review cover areas such as care, communication, palliative care, activities and the environment. Care for an Aboriginal and Torres Strait Islander person in an Australian residential aged-care facility requires a collaborative and individual approach. Cultural safety principles should be maintained across a culturally competent workforce. Aboriginal and Torres Strait Islander persons in care is a significant experience that should not be considered 'routine' as there is much to consider in the care of this person and their community. © 2011 The Author. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  9. Rural and small-town attitudes about alcohol use during pregnancy: a community and provider sample.

    Science.gov (United States)

    Logan, T K; Walker, Robert; Nagle, Laura; Lewis, Jimmie; Wiesenhahn, Donna

    2003-01-01

    While there has been considerable research on prenatal alcohol use, there have been limited studies focused on women in rural and small-town environments. This 2-part study examines gender differences in attitudes and perceived barriers to intervention in large community sample of persons living in rural and small-town environments in Kentucky (n = 3,346). The study also examines rural/small-town prenatal service providers' perceptions of barriers to assessment and intervention with pregnant substance abusers (n = 138). Surveys were administered to a convenience sample of employees and customers from 16 rural and small-town community outlets. There were 1503 males (45%) and 1843 females (55%) ranging in age from under 18 years old to over 66 years old. Surveys also were mailed to prenatal providers in county health departments of the 13-county study area, with 138 of 149 responding. Overall results of the community sample suggest that neither males nor females were knowledgeable about the harmful effects of alcohol use during pregnancy. Results also indicate substantial gender differences in alcohol attitudes, knowledge, and perceived barriers. Further, prenatal care providers identified several barriers in assessment and treatment of pregnant women with alcohol use problems in rural and small-town communities, including lack of knowledge and comfort with assessment as well as a lack of available and accessible treatment for referrals.

  10. Human Immunodeficiency Virus Infection in a rural community of ...

    African Journals Online (AJOL)

    Human Immunodeficiency Virus Infection in a rural community of Plateau State: effective control measures still a nightmare? GTA Jombo, DZ Egah, EB Banwat. Abstract. No Abstract. Nigerian Journal of Medicine Vol. 15(1) 2006: 49-52. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...

  11. Community attachment and resource harvesting in rural Denmark

    Science.gov (United States)

    Rodney R. Zwick; David Solan

    2002-01-01

    Community attachment has been related to "sense of place," and by extension to factors such as the natural resource base of a local geographic area and the utilitarian uses of those resources-a functional attachment that helps root people to a place. The purpose of this study was to examine the resource harvest activities of residents of three modern rural...

  12. Joys and challenges of relationships in Scotland and New Zealand rural midwifery: A multicentre study.

    Science.gov (United States)

    Crowther, Susan; Deery, Ruth; Daellenbach, Rea; Davies, Lorna; Gilkison, Andrea; Kensington, Mary; Rankin, Jean

    2018-04-21

    Globally there are challenges meeting the recruitment and retention needs for rural midwifery. Rural practice is not usually recognised as important and feelings of marginalisation amongst this workforce are apparent. Relationships are interwoven throughout midwifery and are particularly evident in rural settings. However, how these relationships are developed and sustained in rural areas is unclear. To study the significance of relationships in rural midwifery and provide insights to inform midwifery education. Multi-centre study using online surveys and discussion groups across New Zealand and Scotland. Descriptive and template analysis were used to organise, examine and analyse the qualitative data. Rural midwives highlighted how relationships with health organisations, each other and women and their families were both a joy and a challenge. Social capital was a principal theme. Subthemes were (a) working relationships, (b) respectful communication, (c) partnerships, (d) interface tensions, (e) gift of time facilitates relationships. To meet the challenges of rural practice the importance of relationship needs acknowledging. Relationships are created, built and sustained at a distance with others who have little appreciation of the rural context. Social capital for rural midwives is thus characterised by social trust, community solidarity, shared values and working together for mutual benefit. Rural communities generally exhibit high levels of social capital and this is key to sustainable rural midwifery practice. Midwives, educationalists and researchers need to address the skills required for building social capital in rural midwifery practice. These skills are important in midwifery pre- and post-registration curricula. Copyright © 2018 Australian College of Midwives. All rights reserved.

  13. Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research.

    Science.gov (United States)

    Cochran, Gerald T; Engel, Rafael J; Hruschak, Valerie J; Tarter, Ralph E

    2017-10-01

    Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids. Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse. We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse. A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse. Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.

  14. Oral Health in Rural Communities

    Science.gov (United States)

    ... people with partial edentulism when compared to urban (Urban, 38.4%, High Poverty Rural 51.3%, Other Rural, 45%). Counties with high rates of full edentulism are also rural (Urban, 4.3%, High-Poverty Rural 10.5%, Other Rural, 8.2%). ( Mitchell, ...

  15. Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria.

    Science.gov (United States)

    Senbanjo, Idowu O; Olayiwola, Ibiyemi O; Afolabi, Wasiu A O

    2016-01-01

    Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother-child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P rural communities.

  16. ‘It’s about the smoke, not the smoker’: messages that motivate rural communities to support smoke-free policies

    Science.gov (United States)

    Kostygina, Ganna; Hahn, Ellen J.; Rayens, Mary Kay

    2014-01-01

    Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities. PMID:23969628

  17. Adiposity and Insulin Resistance in Children from a Rural Community in Mexico.

    Science.gov (United States)

    Barbosa-Cortes, Lourdes; Villasis-Keever, Miguel Angel; Del Prado-Manriquez, Martha; Lopez-Alarcon, Mardia

    2015-04-01

    The study of the incidence of overweight and obesity as well as body composition and insulin resistance in children from rural communities is scarce. The aims of the study were a) to characterize the adiposity and homeostasis model assessment of insulin resistance (HOMA-IR) in school-age children from a rural community and b) to determine factors associated with fat mass and HOMA-IR in this population. A total of 41 school-aged children (15 males and 26 females; 9.9 ± 2.5 years old) from a Mexican rural community was studied. Trained observers had previously assessed the children's nutritional status during the first 6 months of life. Anthropometry, energy intake, physical activity, body composition and biochemical parameters were measured. The overall prevalence of overweight/obesity was 7.3%. The mean energy intake of children was below international recommendations (1,235 ± 400 kcal/day). A higher percentage of fat mass was observed in females (20.3 ± 8.5) than in males (14.1 ± 5.1) (p = 0.006). There were seven children with IR, but we did not observe a correlation between HOMA and BMI percentiles (Pearson's r = 0.09, p = 0.57). In a regression model, gender (females) was the primary factor associated with the percentage of fat mass. The growth velocity during the first 6 months of life was associated with HOMA-IR. There is a low frequency of overweight and obesity in children from rural communities in Mexico. However, these children appear to have increased risk of adiposity and insulin resistance. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.

  18. Desired attributes of new graduate nurses as identified by the rural community.

    Science.gov (United States)

    Sivamalai, S

    2008-01-01

    Preparing nurse graduates for practice is challenging because of the diversity of skills expected of them. Increasingly consumers are more informed and expect quality care. To identify the attributes a rural community expect in new graduate nurses in order for them to provide quality care. A questionnaire was designed to assess the importance attached to a set of attributes of graduate nurses expected by a rural community. The community included a range of professionals working with government and hospitals, community volunteers and retired people. After pilot testing, the questionnaire was distributed using a cluster sampling technique. A total of 656 completed questionnaires were returned, giving a response rate of 69%. The respondents were asked to rate the importance of each item for the community on a five-point Likert scale (5 = extremely important, 4 = very important, 3 = moderately important, 2 = possibly importantly, and 1 = not important at all). Exploratory factor analysis was performed on the 38 items using SPSS (SPSS inc; Chicago, IL, USA). Principal Components Analysis was applied to identify the number of factors followed by Oblimin rotation. The sample of 656 respondents consisted of 68% females and 30% males (2% did not identify their gender). The majority of the respondents (75.6%) were born in Australia, while 3.2% were born in the UK Kingdom. Principal Components Analysis identified five factors with eigenvalues above one, explaining 47.4% of the total variance. Items that loaded greater than + or - 0.3, (approximately 10% of the common factor variance) was associated with the factor in question. Component 1 was labelled Sympathetic/ Patients' welfare with the item 'Nurses should be sensitive to the emotional needs of patients' showing the highest loading. Component 2 was called Contextual knowledge/ Interpersonal skills. It contained items indicating that nurses should have good personal skills and possess a broad contextual knowledge of issues

  19. Community-Level Exposure to the Rural Mining Industry: The Potential Influence on Early Adolescent Alcohol and Tobacco Use.

    Science.gov (United States)

    Gay, Christopher; Clements-Nolle, Kristen; Packham, John; Ackerman, Gerald; Lensch, Taylor; Yang, Wei

    2018-01-31

    Rural youth have higher rates of alcohol and tobacco use compared to their urban counterparts. However, the economic dependence of rural communities may differentially influence risk behaviors. While research has shown that adults working in mining have elevated rates of alcohol and tobacco use, the influence of living in a mining community on early adolescent substance use is unknown. Using data from a representative sample of 4,535 middle school students in a state with heavy reliance on mining, we conducted weighted logistic regression to investigate whether community-level mining economic dependence influences rural-urban differences in adolescent alcohol and tobacco use. All models adjusted for sociodemographics, military family involvement, parental monitoring, and length of residence. Over one quarter of the sampled students lived in rural counties and approximately half of these counties met the USDA mining economic typology. After stratifying rural counties by mining and nonmining economic dependence, students in rural mining counties had significantly higher odds of all measures of alcohol use (AORs ranged from 1.83 to 3.99) and tobacco use (AORs ranged from 1.61 to 5.05) compared to students in urban counties. Only use of smokeless tobacco was higher among students in rural nonmining counties. Our findings demonstrate rural-urban disparities in adolescent substance use that are particularly pronounced among youth living in counties with economic dependence on mining. Future research on this subject should include a wider range of community-level factors that may have specific relevance in rural settings to inform the development of population-level interventions. © 2018 National Rural Health Association.

  20. Tungiasis in rural communities of Badagry Local Government Area ...

    African Journals Online (AJOL)

    An epidemiological study was conducted to determine the prevalence and risk factors to tungiasis amongst 1,030 randomly selected individuals in rural communities of Badagry Local Government Area of Lagos State, Nigeria. Hands, feet, elbows and other parts of the body were examined for the presence of clinical signs of ...

  1. Psychosocial investigation of individual and community responses to the experience of Ovine Johne's Disease in rural Victoria.

    Science.gov (United States)

    Hood, Bernadette; Seedsman, Terence

    2004-04-01

    This paper explores the psychosocial outcomes for individuals and communities in rural Victoria who experienced the outbreak of Ovine Johne's Disease (OJD). The study uses a qualitative methodology to analyse the minutes of evidence provided by the inquiry into the control of OJD to identify the psychosocial events, experiences and outcomes associated with the control of this outbreak. The inquiry was undertaken by the Environment and Natural Resources Committee of the Victorian State Government. Public hearings were undertaken by the committee across several rural Victorian communities and the state capital, Melbourne. The transcripts detail 136 submissions from 98 individuals and 23 organisations. The analysis aimed to provide insight into the impact of the disease on individuals and communities and also to explore the factors individuals perceived as associated with these outcomes. While the paper identifies that aspects of stock loss associated with the outbreak caused substantial emotional and economic distress, for farmers the most significant finding was the impact of the government control program on individuals, families and rural communities. The control program was perceived as having very limited scientific credibility and its implementation was described as heartless, inflexible and authoritarian. Involvement with the program resulted in farmers reporting emotions, such as, trauma, shame, guilt and stigma. Families became discordant and the sense of community within rural townships fragmented. Psychological outcomes of grief, depression and anxiety emerged as prevalent themes within families and communities. These data highlight the need for significant attention to the management of rural disasters, such as, the OJD program. There is an acknowledgement in the literature that rural disasters have a significant impact on the well-being of individuals, families and communities. The major focus of the previous research has, however, been on the impact of

  2. Cost-effectiveness of community screening for glaucoma in rural India: a decision analytical model.

    Science.gov (United States)

    John, D; Parikh, R

    2018-02-01

    Studies in several countries have demonstrated the cost-effectiveness of population-based screening for glaucoma when targeted at high-risk groups such as older adults and with familial history of disease. This study conducts a cost-effective analysis of a hypothetical community screening and subsequent treatment programme in comparison to opportunistic case finding for glaucoma in rural India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in rural areas of India. A decision analytical model was built to model events, costs and treatment pathways with and without a hypothetical screening programme for glaucoma for a rural-based population aged between 40 and 69 years in India. The treatment pathway included both primary open-angle glaucoma and angle-closure disease. The data on costs of screening and treatment were provided by an administrator of a tertiary eye hospital in Eastern India. The probabilities for the screening and treatment pathway were derived from published literature and a glaucoma specialist. The glaucoma prevalence rates were adapted from the Chennai Glaucoma Study findings. An incremental cost-effectiveness ratio value of ₹7292.30 per quality-adjusted life-year was calculated for a community-screening programme for glaucoma in rural India. The community screening for glaucoma would treat an additional 2872 cases and prevent 2190 person-years of blindness over a 10-year period. Community screening for glaucoma in rural India appears to be cost-effective when judged by a ratio of willingness-to-pay thresholds as per WHO-CHOICE guidelines. For community screening to be cost-effective, adequate resources, such as trained medical personnel and equipment would need to be made available. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. An experiment in using open-text comments from the Australian Rural Mental Health Study on health service priorities.

    Science.gov (United States)

    Rich, Jane; Handley, Tonelle; Inder, Kerry; Perkins, David

    2018-02-01

    Conducting research in rural and remote areas is compounded by challenges associated with accessing relatively small populations spread over large geographical areas. Open-ended questions provided in a postal survey format are an advantageous way of including rural and remote residents in research studies. This method means that it is possible to ask for in-depth perspectives, from a large sample, in a relatively resource-efficient way. Such questions are frequently included in population-based surveys; however, they are rarely analysed. The aim of this article is to explore word cloud analysis, to evaluate the utility of automated programs to supplement the analysis of open-ended survey responses. Participants from the Australian Rural Mental Health Study completed the open-ended question 'What health services would you like to see the local health district providing that are currently not available in your area?' A word cloud analysis was then undertaken using the program Wordle; the size of the word in the cloud illustrates how many times, in proportion to other words, a word has appeared in responses, and provides an easily interpretable visual illustration of research results. In total, 388 participants provided a response to the free-text question. Using the word cloud as a visual guide, key words were identified and used to locate relevant quotes from the full open-text responses. \\'Mental health\\' was the most frequent request, cited by 81 people (20.8%). Following mental health, requests for more \\'specialists\\' (n=59) and \\'services\\' (n=53) were the second and third most frequent responses respectively. Visiting specialists were requested by multiple respondents (n=14). Less frequent requests illustrated in the word cloud are important when considering representatives from smaller population groups such as those with specific health needs or conditions including \\'maternity\\' services (n=13), \\'cancer\\' (n=10), \\'drug and alcohol\\' services

  4. Mobile crisis management teams as part of an effective crisis management system for rural communities.

    Science.gov (United States)

    Trantham, Doug; Sherry, Anne

    2012-01-01

    Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.

  5. Neighbourhood and Community Experience, and the Quality of Life of Rural Adolescents with and without an Intellectual Disability.

    Science.gov (United States)

    Pretty, Grace; Rapley, Mark; Bramston, Paul

    2002-01-01

    A comparison of 14 Australian adolescents with mild intellectual disabilities and 13 typical adolescents found no significant differences between the groups on community usage and lifestyle patterns. The discussion promotes the inclusion of community factors when investigating community integration of adolescents with a disability. (Contains…

  6. Perceptions of the Environment for Eating and Exercise in a Rural Community

    Science.gov (United States)

    Maley, Mary Maly; Warren, Barbour S.; Devine, Carol M.

    2010-01-01

    Objective: To understand how members of a rural community perceive the effect of the built, natural, and social environments on their food choice and physical activity behaviors. Methods: A constructivist community environmental assessment was conducted including 17 individual qualitative interviews, 2 focus groups, and photo elicitation (n = 27)…

  7. The Cooperative Organization And Rural Passenger Transportation: An Approach to Community Development.

    Science.gov (United States)

    Stommes, Eileen S.

    The need for passenger transportation is widely recognized by rural communities. Shrinking federal funding has led many communities and human service agencies to experiment with innovative approaches to provide transportation services. One such approach is the use of cooperative organizations to provide needed services. A study conducted by the…

  8. Linking rural community livelihoods to resilience building in flood risk reduction in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Patrick Gwimbi

    2009-04-01

    Full Text Available The increasing occurrence of disastrous flooding events and the mounting losses in both life and property values in Zimbabwe have drawn attention to the flooding situation in the country, especially the rural areas. This article explores the resilience of vulnerable rural communities to flood risks associated within increasingly frequent and severe events linked to climate change. Starting by reviewing the current literature on rural livelihoods, resilience and vulnerability research, the paper argues for a coordinated teamwork approach in flood risk mitigation in rural areas. The paper concludes with several recommendations for enhanced resilience to flood hazards.

  9. Cultural Context of School Communities in Rural Hawaii to Inform Youth Violence Prevention

    Science.gov (United States)

    Affonso, Dyanne D.; Mayberry, Linda; Shibuya, June Y.; Archambeau, Olga G.; Correa, Mary; Deliramich, Aimee N.; Frueh, B. Christopher

    2010-01-01

    Background: Escalation of youth violence within a large geographic school-complex area in southeastern rural Hawaii became a major problem in 2006. How cultural forces impact the problem was an impetus to examine youth violence from perspectives of adults and children in rural communities. Gathering these data was an essential first step toward…

  10. PRODUCTIVE ACTIVITIES IN RURAL SCHOOLS: A COMMUNITY MISSION OF THE EXECUTIVE

    Directory of Open Access Journals (Sweden)

    Lorena del Rosario Piñero

    2014-04-01

    Full Text Available The intention of the study consisted of valuing the productive activities for rural schools from the community mission that the executive exercises in the educational context of the Parish Ana Maria Campos, municipality Elevated place, condition Zulia. The study was considered to be descriptive, to such effects his basic action consisted of the valuation of elements considered like fundamental to identify the productive activities in rural schools from the community mission of the executive. The design of the investigation is not experimental, of field, transactional with a methodology qualitative and quantitative of dominant quantitative approach carried out in the educational context of the communities El Mecocal, El Crespo, El Rodeo, La Quebrada y el Kilometro 42. The population was constituted by teachers, parents and rural representatives to whom an instrument applied comprising questionnaire of 15 questions type Likert and 5 questions opened of triple version, validated in his content by 10 experts whose results were valued for categories and processed statistically across percentage tests. Between the conclusions there was demonstrated that the pedagogic practices are based basically on the approximation of executives and teachers by prevalence in knowing the expectations of learning of the pupils, the performance of the executives is estimated by good disposition by the teachers and the productive projects are realized across the education of the theoretical contents in the classroom of classes.

  11. Promoting physical activity among children and youth in disadvantaged South Australian CALD communities through alternative community sport opportunities.

    Science.gov (United States)

    Rosso, Edoardo; McGrath, Richard

    2016-02-29

    Issue addressed: Recently arrived migrants and refugees from a culturally and linguistically diverse background (CALD) may be particularly vulnerable to social exclusion. Participation in sport is endorsed as a vehicle to ease the resettlement process; however, in Australia, this is often thought as a simple matter of integration into existing sport structures (e.g. clubs). This approach fails to place actual community needs at the centre of sport engagement efforts. Methods: A consultation framework was established with South Australian CALD community leaders and organisations to scope needs for community-based alternatives to participation in traditional sport (e.g. clubs), co-design a suitable community sport program and pilot it in five communities. Interviews and questionnaire surveys were conducted with participants, community representatives, stakeholders and volunteers. Results: Regular, free soccer activities engaged 263 young people from a great variety of nationalities, including over 50% refugees, in secondary state school and community-based sites. Conclusion: Alternative community sport programs can provide a basic but valuable forum to promote physical activity and associated well being in CALD and refugee communities. So what?: Alternative approaches can extend the health benefits of sport participation to disadvantaged children and youth who are excluded from traditional sport participation opportunities.

  12. Making basic health care accessible to rural communities: a case study of Kiang West district in rural Gambia.

    Science.gov (United States)

    Sanneh, Edward Saja; Hu, Allen H; Njai, Modou; Ceesay, Omar Malleh; Manjang, Buba

    2014-01-01

    This study focuses on lack of access to basic health care, which is one of the hindrances to the development of the poor, and subjects them to the poverty penalty. It also focuses on contributing to the Bottom of the Pyramid in a general sense, in addition to meeting the health needs of communities where people live on less than $1 a day. Strengthened multistakeholder responses and better-targeted, low-cost prevention, and care strategies within health systems are suggested to address the health burdens of poverty-stricken communities. In this study, a multistakeholder model which includes the government, World Health Organization, United Nations Children Emergency Fund, and the Medical Research Council was created to highlight the collaborative approach in rural Gambia. The result shows infant immunization and antenatal care coverage were greatly improved which contributes to the reduction in mortality. This case study also finds that strategies addressing health problems in rural communities are required to achieve 'Millennium Development Goals'. In particular, actual community visits to satellite villages within a district (area of study) are extremely vital to making health care accessible. © 2013 Wiley Periodicals, Inc.

  13. Mobile technologies for preservation of indigenous knowledge in rural communities

    DEFF Research Database (Denmark)

    Winschiers-Theophilus, Heike; Rodil, Kasper; Zaman, Tariq

    2013-01-01

    In this paper we explore the opportunities of mobile technologies in three of our own development endeavors with rural communities, promoting the preservation of indigenous knowledge. We reflect upon and recognize the fact that the representation of indigenous knowledge will be transformed within...

  14. Community : a powerful label? Connecting wind energy to rural Ireland

    NARCIS (Netherlands)

    Walsh, B.M.

    2016-01-01

    Much of the research on the social sustainability of renewable technologies has focused on local acceptance issues, community benefits from exogenous developments, and matters related to the planning and development process. Grassroots-initiated wind energy schemes as a form of rural enterprise have

  15. Mapping Point-of-Purchase Influencers of Food Choice in Australian Remote Indigenous Communities

    Directory of Open Access Journals (Sweden)

    Joanna Henryks

    2016-02-01

    Full Text Available Closing the health gap between Indigenous and non-Indigenous Australians relies, in part, on addressing the poor levels of nutrition in remote Indigenous communities (RIC. This article identifies and maps key influencers of food choice at the point-of-purchase (POP in Australian RIC and identifies gaps in our knowledge. It is based on a narrative review of the literature pertaining to food in RIC from a range of disciplinary perspectives including nutrition, ethnography, public health, anthropology, and remote health to map POP drivers of food choice. In particular, the role of habit is identified as a key factor that has previously not been discussed in the literature. The conceptual framework can be used as a basis for future POP research in RIC and provides guidance for social marketers, public health, nutrition, and policy workers operating in this field.

  16. Microbial communities of three sympatric Australian stingless bee species.

    Directory of Open Access Journals (Sweden)

    Sara D Leonhardt

    Full Text Available Bacterial symbionts of insects have received increasing attention due to their prominent role in nutrient acquisition and defense. In social bees, symbiotic bacteria can maintain colony homeostasis and fitness, and the loss or alteration of the bacterial community may be associated with the ongoing bee decline observed worldwide. However, analyses of microbiota associated with bees have been largely confined to the social honeybees (Apis mellifera and bumblebees (Bombus spec., revealing--among other taxa--host-specific lactic acid bacteria (LAB, genus Lactobacillus that are not found in solitary bees. Here, we characterized the microbiota of three Australian stingless bee species (Apidae: Meliponini of two phylogenetically distant genera (Tetragonula and Austroplebeia. Besides common plant bacteria, we find LAB in all three species, showing that LAB are shared by honeybees, bumblebees and stingless bees across geographical regions. However, while LAB of the honeybee-associated Firm4-5 clusters were present in Tetragonula, they were lacking in Austroplebeia. Instead, we found a novel clade of likely host-specific LAB in all three Australian stingless bee species which forms a sister clade to a large cluster of Halictidae-associated lactobacilli. Our findings indicate both a phylogenetic and geographical signal of host-specific LAB in stingless bees and highlight stingless bees as an interesting group to investigate the evolutionary history of the bee-LAB association.

  17. Microbial Communities of Three Sympatric Australian Stingless Bee Species

    Science.gov (United States)

    Leonhardt, Sara D.; Kaltenpoth, Martin

    2014-01-01

    Bacterial symbionts of insects have received increasing attention due to their prominent role in nutrient acquisition and defense. In social bees, symbiotic bacteria can maintain colony homeostasis and fitness, and the loss or alteration of the bacterial community may be associated with the ongoing bee decline observed worldwide. However, analyses of microbiota associated with bees have been largely confined to the social honeybees (Apis mellifera) and bumblebees (Bombus spec.), revealing – among other taxa – host-specific lactic acid bacteria (LAB, genus Lactobacillus) that are not found in solitary bees. Here, we characterized the microbiota of three Australian stingless bee species (Apidae: Meliponini) of two phylogenetically distant genera (Tetragonula and Austroplebeia). Besides common plant bacteria, we find LAB in all three species, showing that LAB are shared by honeybees, bumblebees and stingless bees across geographical regions. However, while LAB of the honeybee-associated Firm4–5 clusters were present in Tetragonula, they were lacking in Austroplebeia. Instead, we found a novel clade of likely host-specific LAB in all three Australian stingless bee species which forms a sister clade to a large cluster of Halictidae-associated lactobacilli. Our findings indicate both a phylogenetic and geographical signal of host-specific LAB in stingless bees and highlight stingless bees as an interesting group to investigate the evolutionary history of the bee-LAB association. PMID:25148082

  18. Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

    Science.gov (United States)

    Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie

    2015-01-01

    Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

  19. Problematizing the Relationship between Rural Small Schools and Communities: Implications for Youth Lives

    Science.gov (United States)

    Cuervo, Hernán

    2014-01-01

    Small schools are often the hub of many rural communities. In the school space, a multiplicity of social, economic and political relationships are sustained, which enhance the vitality of the community. As such, the relationship between small schools and communities is often presented as a powerful one; however, too often as a harmonious, natural…

  20. Being Involved in the Country: Productive Ageing in Different Types of Rural Communities

    Science.gov (United States)

    Davis, Sandra; Crothers, Natalie; Grant, Jeanette; Young, Sari; Smith, Karly

    2012-01-01

    Productive ageing recognises the contribution of older people to economic, social and cultural growth and helps build a sustainable community. Being involved in community life is good for individuals and good for society. However, we know very little about the participation of and contribution by people aged 50 and over in rural communities. This…

  1. Obstetric referrals from a rural clinic to a community hospital in Honduras.

    Science.gov (United States)

    Josyula, Srirama; Taylor, Kathryn K; Murphy, Blair M; Rodas, Dairamise; Kamath-Rayne, Beena D

    2015-11-01

    referrals between health care facilities are important in low-resource settings, particularly in maternal and child health, to transfer pregnant patients to the appropriate level of obstetric care. Our aim was to characterise the obstetrical referrals from a rural clinic to a community referral hospital in Honduras, to identify barriers in effective transport/referral, and to describe subsequent patient outcomes. we performed a descriptive retrospective study of patients referred during a 9-month period. We reviewed patient charts to review diagnosis, referral, and treatment times at both sites to understand the continuity of care. ninety-two pregnant patients were referred from the rural clinic to the community hospital. Twenty six pregnant patients (28%) did not have complete and accurate medical records and were excluded from the study. The remaining 66 patients were our study population. Of the 66 patients, 54 (82%) received antenatal care with an average of 5.5±2.4 visits. The most common diagnoses requiring referral were non-reassuring fetal status, hypertensive disorders of pregnancy, and preterm labour. The time spent in the rural clinic until transfer was 7.35±8.60 hours, and transport times were 4.42±1.07 hours. Of the 66 women transferred, 24 (36%) had different primary diagnoses and 16 (24%) had additional diagnoses after evaluation in the community hospital, whereas the remaining 26 (40%) had diagnoses that remained the same. No system was in place to give feedback to the referring clinic doctors regarding their primary diagnoses. our results demonstrate challenges seen in obstetric transport from a rural clinic to a community hospital in Honduras. Further research is needed for reform of emergency obstetric care management, targeting both healthcare personnel and medical referral infrastructure. The example of Honduras can be taken to motivate change in other resource-limited areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Medical students' and GP registrars' accommodation needs in the rural community: insight from a Victorian study.

    Science.gov (United States)

    Han, Gil-Soo; Wearne, Ben; O'Meara, Peter; McGrail, Matthew; Chesters, Janice

    2003-01-01

    Medical education in Australia is currently entering a new era, including support for the significant extension of medical students and general practitioner (GP) registrars' training programs in rural communities. This commitment to rural medical student and general practitioner recruitment and retention has made the provision of accommodation in rural communities a vital issue. This study has found that approximately half of all medical students on placement with rural GPs are currently accommodated with their GP supervisor or with other practice staff. This is a burden for many GPs and when the anticipated increase in the frequency and length of rural placements occurs what is currently a burden will become unsustainable. The changing gender and cultural demographics of medical students and rural general practitioners will also contribute to stresses on this accommodation system. It is important to have a systematic approach towards more appropriate and sustainable models of accommodation for both medical students and GP registrars.

  3. Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-06-01

    Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with

  4. POISON CONTROL—Operation of an Information Center in a Rural and Agricultural Community

    Science.gov (United States)

    Bocian, J. J.

    1960-01-01

    The Fresno Community Hospital Poison Control Center has been in operation for about three years, under the sole directorship of the pathologist. All expenses are paid by the hospital. It has served a definite need in the community. As an agricultural and more or less rural community, it shows more poison cases having to do with plants, insecticides, kerosene and fertilizers than do urban communities. PMID:13801875

  5. The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.

    Science.gov (United States)

    Lloyd, Jane E; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F

    2015-07-22

    Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community. Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community. Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services. For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive

  6. Determinants of Full Vaccination Status in a Rural Community with ...

    African Journals Online (AJOL)

    Femi

    Department of Community Health, University of Benin Teaching Hospital, Benin City, Nigeria. INTRODUCTION ... Low vaccination coverage in rural areas in Nigeria is associated with ... the requested information in addition to playing ... More than one-third, 109 .... Perceived benefits of vaccination and risks of vaccine-.

  7. Community management and sustainability of rural water facilities in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.; Butijn, C.A.A.; Niehof, Anke

    2013-01-01

    This paper addresses the question of whether community management in water service delivery affects the sustainability of rural water facilities (RWFs) at village level, in terms of their technical and managerial aspects, and what role capacity building of users and providers plays in this process.

  8. Detachment from conventional agriculture in rural Japan: An analysis of embedded antifragility in satoyama communities

    OpenAIRE

    Mathé, Daniel Hesby

    2013-01-01

    The thesis examines how socioeconomic and socioecologic changes in rural Japan have affected the embedded antifragility of rural satoyama communities. These communities have traditionally had a high degree of self-sufficiency and been detached from input systems based on synthetic agrichemicals and debt. I spent a month in the Hida region of Japan, where I interviewed villagers in a small mountain village, representatives from the local municipality and observed the conditions for satoyama in...

  9. Community and consumer participation in Australian health services--an overview of organisational commitment and participation processes.

    Science.gov (United States)

    Johnson, A; Silburn, K

    2000-01-01

    This article briefly describes recent initiatives to improve consumer participation in health services that have led to the establishment of the National Resource Centre for Consumer Participation in Health. The results of a component of the needs assessment undertaken by the newly established Centre are presented. They provide a 'snapshot' of the types of feedback and participation processes mainly being utilised by Australian health services at the different levels of seeking information, information sharing and consultation, partnership, delegated power and consumer control. They also allow identification of the organisational commitment made by Australian health services to support a more coordinated approach to community and consumer feedback and participation at different levels of health services such as particular emphasis on determining the presence of community and consumer participation in key organisational statements, specific consumer policies and plans, identifiable leadership, inclusion into job descriptions, allocation of resources, and staff development and consumer training. Discussion centres around four key observations and some of the key perceived external barriers.

  10. Community perceptions of a rural medical school: a pilot qualitative study

    Directory of Open Access Journals (Sweden)

    Nestel D

    2014-11-01

    Full Text Available Debra Nestel,1 Katherine Gray,1 Margaret Simmons,1 Shane A Pritchard,1 Rumana Islam,1 Wan Q Eng,1 Adrian Ng,1 Tim Dornan2 1Gippsland Medical School/School of Rural Health, Monash University, Clayton, Australia; 2School of Health Professions Education, Maastricht University, Maastricht, the Netherlands Background: This paper explores local community perceptions of a relatively new rural medical school. For the purposes of this paper, community engagement is conceptualized as involvement in planning, delivering, and evaluating the medical program. Although there are several reviews of patient involvement in medical curricula development, this study was designed to pilot an approach to exploring the perspectives of well members of the community in the transition of institutional policy on community engagement to one medical school. Methods: An advertisement in the local newspaper invited volunteers to participate in a telephone interview about the new medical school. An independent researcher external to the medical school conducted the interviews using a topic guide. Audio recordings were not made, but detailed notes including verbatim statements were recorded. At least two research team members analyzed interview records for emergent themes. Human research ethics approval was obtained. Results: Twelve interviews were conducted. Participants offered rich imaginings on the role of the school and expectations and opportunities for students. Most participants expressed strong and positive views, especially in addressing long-term health workforce issues. It was considered important that students live, mix, and study in the community. Some participants had very clear ideas about the need of the school to address specified needs, such as indigenous health, obesity, aging, drug and alcohol problems, teenage pregnancy, ethnic diversity, and working with people of low socioeconomic status. Conclusion: This study has initiated a dialogue with potential

  11. Prevalence of smoking among youth in a rural Nigerian community ...

    African Journals Online (AJOL)

    Prevalence of smoking among youth in a rural Nigerian community. K O Osungbade, F O Oshiname. Abstract. No Abstract. Tropical Journal of Health Sciences Vol. 15 (1) 2008: pp. 44-48. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  12. Similarities of School Shootings in Rural and Small Town Communities.

    Science.gov (United States)

    Kidd, Scott T.; Meyer, Cheryl L.

    2002-01-01

    A study examined characteristics common among young offenders from rural communities who were involved in multiple-fatality school shootings. Data on six cases involving eight offenders revealed six common offender characteristics: verbal threats, peer rejection, interest in violent media, previous violent behavior, suicidal ideation, and violent…

  13. Exploring Cultural Horizons: Connecting Australian Students with Asian Students via Video-Conferencing

    Science.gov (United States)

    Reading, Chris; Auh, Myung-Sook; Pegg, John; Cybula, Peter

    2013-01-01

    The need for Australian school students to develop a strong understanding of Asian culture has been recognised in the cross-curriculum priority, "Asia and Australia's Engagement with Asia," of the Australian Curriculum. School students in rural and remote Australia have limited opportunities to engage with Asians and learn about their…

  14. Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians

    Directory of Open Access Journals (Sweden)

    Matthew West

    2017-11-01

    Full Text Available Abstract Background The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. Methods MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Results Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91% while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Conclusions Aboriginal and Torres Strait Islander

  15. Active Citizenship and the Secondary School Experience: Community Participation Rates of Australian Youth. Research Report Number.

    Science.gov (United States)

    Brown, Kevin; Lipsig-Mumme, Carla; Zajdow, Grazyna

    Volunteering is often seen as an essential element in active citizenship and community participation, and existing literature suggests that those who volunteer young are more likely to volunteer through later stages of life. Analysis of Longitudinal Surveys of Australian Youth (LSAY), which identified factors that contribute to volunteering for…

  16. Australian primary school communities' understandings of SunSmart: a qualitative study.

    Science.gov (United States)

    Winslade, Matthew; Wright, Bradley; Dudley, Dean; Cotton, Wayne; Brown, Alexandra

    2017-10-01

    Skin cancer represents a major health issue for Australia. Childhood sun exposure is an important risk factor and evidence suggests the use of sun protection measures by Australian school children could be improved. This study examines how the SunSmart Program, a school-based skin cancer prevention resource, can be supported to further increase sun protection behaviours to assist in lowering skin cancer incidence. The Health Promoting Schools (HPS) framework was adopted to select key stakeholders from a convenience sample of five school communities. Students, teaching staff and parents participated in semi-structured focus group and individual interviews. A thematic analysis was used to extract key themes from the data. Although these school communities were aware of sun protection practices and the risks associated with sun exposure, their understandings of the SunSmart Program were limited. Sun protection policy implementation was inconsistent and students were unlikely to engage in sun protection practices beyond the school setting. School communities require additional support and engagement to holistically enforce the principles of the SunSmart Program. © 2017 The Authors.

  17. Community health workers as cultural producers in addressing gender-based violence in rural South Africa.

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2016-01-01

    South Africa has been experiencing an epidemic of gender-based violence (GBV) for a long time and in some rural communities health workers, who are trained to care for those infected with HIV, are positioned at the forefront of addressing this problem, often without the necessary support. In this article, we pose the question: How might cultural production through media making with community health workers (CHWs) contribute to taking action to address GBV and contribute to social change in a rural community? This qualitative participatory arts-based study with five female CHWs working from a clinic in a rural district of South Africa is positioned as critical research, using photographs in the production of media posters. We offer a close reading of the data and its production and discuss three data moments: CHWs drawing on insider cultural knowledge; CHWs constructing messages; and CHWs taking action. In our discussion, we take up the issue of cultural production and then offer concluding thoughts on 'beyond engagement' when the researchers leave the community.

  18. Using Forest Certification to Strengthen Rural Communities: Cases from Northwest Russia.

    NARCIS (Netherlands)

    Meidinger, E.; Tysiachniouk, M.S.

    2006-01-01

    The rapid globalization of forest products markets has placed many rural forest-based communities under considerable pressure to rapidly exploit forest resources. To counter, transnational environmental organizations have promoted programs for forest certification, seeking to use global market

  19. Symbiotic Relationship between Telecentre and Lifelong Learning for Rural Community Development: A Malaysian Experience

    Science.gov (United States)

    Malek, Jalaluddin Abdul; Razaq Ahmad, Abdul; Mahzan Awang, Mohd; Alfitri

    2014-01-01

    Telecentres in the 21st century may be able to improve standard of living, quality of life, and stability of knowledge for the rural population. The role of telecentres is widely increasing in developing political and management awareness, economic, socio-culture, technology, education and regulation awareness in rural communities. Telecentres in…

  20. Role of community pharmacists in asthma – Australian research highlighting pathways for future primary care models

    Directory of Open Access Journals (Sweden)

    Saini B

    2011-04-01

    Full Text Available Asthma is one of the most common chronic conditions affecting the Australian population. Amongst primary healthcare professionals, pharmacists are the most accessible and this places pharmacists in an excellent position to play a role in the management of asthma. Globally, trials of many community pharmacy-based asthma care models have provided evidence that pharmacist delivered interventions can improve clinical, humanistic and economic outcomes for asthma patients. In Australia, a decade of coordinated research efforts, in various aspects of asthma care, has culminated in the implementation trial of the Pharmacy Asthma Management Service (PAMS, a comprehensive disease management model. There has been research investigating asthma medication adherence through data mining, ways in which usual asthma care can be improved. Our research has focused on self-management education, inhaler technique interventions, spirometry trials, interprofessional models of care, and regional trials addressing the particular needs of rural communities. We have determined that inhaler technique education is a necessity and should be repeated if correct technique is to be maintained. We have identified this effectiveness of health promotion and health education, conducted within and outside the confines of the pharmacy, in public for a and settings such as schools, and established that this outreach role is particularly well received and increases the opportunity for people with asthma to engage in their asthma management. Our research has identified that asthma patients have needs which pharmacists delivering specialized models of care, can address. There is a lot of evidence for the effectiveness of asthma care by pharmacists, the future must involve integration of this role into primary care.

  1. Culture and healthy lifestyles: a qualitative exploration of the role of food and physical activity in three urban Australian Indigenous communities.

    Science.gov (United States)

    Crowe, Ruth; Stanley, Rebecca; Probst, Yasmine; McMahon, Anne

    2017-08-01

    1) To explore the links between Indigenous Australian children's perspectives on culture, and healthy lifestyle behaviours. 2) To provide insight into how to approach the development of a health intervention targeting lifestyle behaviours in Australian Indigenous children. Seven semi-structured focus groups sessions were conducted with Australian Indigenous children aged 5-12 years living on the South Coast of New South Wales. Audio-recordings were transcribed and thematic analyses were conducted and related to principles of grounded theory. Participants had connections to aspects of Australian Indigenous culture that were embedded in their everyday lives. Healthy lifestyle behaviours (such as healthy eating and physical activity) were found to be interconnected with Australian Indigenous culture and positive emotional wellbeing was identified as an important outcome of connecting Australian Indigenous children to cultural practices. Understanding the importance of culture and its role in healthy lifestyles is critical in the development of health interventions for Indigenous populations. Health interventions embedded with Australian Indigenous culture may have potential to improve physical and emotional health within Australian Indigenous communities. However, it is unlikely that a 'one size fits all' approach to health interventions can be taken. © 2017 The Authors.

  2. Towards a sustainable knowledge management and development perspective approach: The sustainable rural community development portal

    CSIR Research Space (South Africa)

    Chakwizira, J

    2010-09-01

    Full Text Available development. The philosophy and thinking behind the rural community planning portal is that it will act as a seed for the generation of an inclusive and dynamic rural development agenda that is sensitive and relevant to contemporary issues and challenges...

  3. Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2015-03-27

    Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions

  4. A community-driven hypertension treatment group in rural Honduras.

    Science.gov (United States)

    Reiger, Sheridan; Harris, Jeffrey R; Chan, Kwun Chuen Gary; Oqueli, Hector Lopez; Kohn, Marlana

    2015-01-01

    We formed a self-funded hypertension treatment group in a resource-poor community in rural Honduras. After training community health workers and creating protocols for standardized treatment, we used group membership fees to maintain the group, purchase generic medications in bulk on the local market, and hire a physician to manage treatment. We then assessed whether participation in the group improved treatment, medication adherence, and hypertension control. This is a program evaluation using quasi-experimental design and no control group. Using data from the 86 members of the hypertension treatment group, we analyzed baseline and follow-up surveys of members, along with 30 months of clinical records of treatment, medication adherence, and blood pressure readings. Our initial hypertension needs assessment revealed that at baseline, community hypertensives relied on the local Ministry of Health clinic as their source of anti-hypertensive medications and reported that irregular supply interfered with medication adherence. At baseline, hypertension group members were mainly female, overweight or obese, physically active, non-smoking, and non-drinking. After 30 months of managing the treatment group, we found a significant increase in medication adherence, from 54.8 to 76.2% (p<0.01), and hypertension control (<140/90 mmHg), from 31.4 to 54.7% (p<0.01). We also found a mean monthly decrease of 0.39 mmHg in systolic blood pressure (p<0.01). At the end of the 30-month observation period, the local Ministry of Health system had increased provision of low-cost anti-hypertensive medications and adopted the hypertension treatment group's treatment protocols. Formation of a self-funded, community-based hypertension treatment group in a rural, resource-poor community is feasible, and group participation may improve treatment, medication adherence, and hypertension control and can serve as a political driver for improving hypertension treatment services provided by the public

  5. Unintended consequences of regulating drinking water in rural Canadian communities: examples from Atlantic Canada.

    Science.gov (United States)

    Kot, Megan; Castleden, Heather; Gagnon, Graham A

    2011-09-01

    Studies that explore social capital and political will [corrected] in the context of safe drinking water provision in [corrected] Canada are limited. This paper presents findings from a study that examines the capacity of rural Canadian communities to attain regulatory compliance for drinking water. Interviews were conducted with water operators and managers in ten rural communities across Atlantic Canada to identify the burden of compliance arising from the implementation of, and adherence to, drinking water regulations. This research identifies the operator as being particularly burdened by regulatory compliance, often resulting in negative consequences including job stress and a strained relationship with the community they serve. Findings indicate that while regulations are vital to ensuring safe drinking water, not all communities have the resources in place to rise to the challenge of compliance. As a result, some communities are being negatively impacted by these regulations, rather than benefit from their intended positive effect. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Scars of disengagement: perspectives on community leadership and youth engagement in rural South Africa.

    Science.gov (United States)

    Majee, Wilson; Jooste, Karien; Aziato, Lydia; Anakwe, Adaobi

    2017-08-01

    Given the emerging global youth disengagement epidemic, anticipated population growth, and the threat of continued rural-urban migration among young adults, recent research has focused on community leadership practice and the factors that influence youth engagement at the local level. Studying these practices and factors can elicit interventions that can improve youth engagement and youth health. This study engaged South African rural community leaders in interviews to collect perceptions and experiences on community leadership and factors that influence youth engagement and their health behaviors. Content analysis was used to analyze the data. Emergent themes are categorized into four domains: conceptualizations of leadership, current youth behaviors, barriers to youth engagement, and youth leadership opportunities and potential solutions. Findings demonstrate a clear grasp of the concept of community leadership among community leaders, and an awareness of the complex interplay of social, economic and environmental factors on youth disengagement and the potential interventions to promote more youth participation.

  7. What are pregnant women in a rural Niger Delta community's ...

    African Journals Online (AJOL)

    To date, studies have sought cause and effect and have neglected the opinion of the people about what they perceive to be problematic and what they believe constitutes satisfactory maternity service provision. An exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's ...

  8. The influence of international medical electives on career preference for primary care and rural practice.

    Science.gov (United States)

    Law, Iain R; Walters, Lucie

    2015-11-11

    Previous studies have demonstrated a correlation between medical students who undertake international medical electives (IMEs) in resource poor settings and their reported career preference for primary care in underserved areas such as rural practice. This study examines whether a similar correlation exists in the Australian medical school context. Data was extracted from the Medical Schools Outcomes Database (MSOD) of Australian medical students that completed commencing student and exit questionnaires between 2006 and 2011. Student responses were categorized according to preferred training program and preferred region of practice at commencement. The reported preferences at exit of students completing IMEs in low and middle income countries (LMIC) were compared to those completing electives in high income countries (HIC). The effect of elective experience for students expressing a preference for primary care at commencement was non-significant, with 40.32 % of LMIC and 42.11 % of HIC students maintaining a preference for primary care. Similarly there were no significant changes following LMIC electives for students expressing a preference for specialist training at commencement with 11.81 % of LMIC and 10.23 % of HIC students preferring primary care at exit. The effect of elective experience for students expressing a preference for rural practice at commencement was non-significant, with 41.51 % of LMIC and 49.09 % of HIC students preferring rural practice at exit. Similarly there were no significant changes following LMIC electives for students expressing a preference for urban practice at commencement, with 7.84 % of LMIC and 6.70 % of HIC students preferring rural practice at exit. This study did not demonstrate an association between elective experience in resource poor settings and a preference for primary care or rural practice. This suggests that the previously observed correlation between LMIC electives and interest in primary care in

  9. Determinants of late antenatal care presentation in rural and peri-urban communities in South Africa: A cross-sectional study.

    Science.gov (United States)

    Ebonwu, Joy; Mumbauer, Alexandra; Uys, Margot; Wainberg, Milton L; Medina-Marino, Andrew

    2018-01-01

    To investigate and compare determinates for delayed first presentation to antenatal care (ANC) services. A cross-sectional study was conducted amongst pregnant women attending their first ANC visit in rural Capricorn District and peri-urban Tlokwe sub-district communities in South Africa. Data collection included questionnaires and medical record abstraction. Bivariate and multivariate analyses assessed factors associated with late ANC presentation. We recruited 807 pregnant women. Of these, 51% of rural women and 28% of peri-urban women presented late for first ANC. Rural women were more likely to present late for first ANC (AOR = 2.65; 95% CI 1.98-3.55) and report barriers to accessing ANC services (PANC presentation in rural communities was associated with being married (AOR = 2.36; 95% CI 1.33-4.19), employed (AOR = 1.90; 95% CI 1.03-3.50), ANC after presenting early (AOR 0.51; 95% CI 0.30-0.89) and being pregnant for the first time (AOR = 0.56; 95% CI 0.34-0.94). Both rural and peri-urban women had high rates of late presentation for first ANC. However, women in the rural communities were more likely to present late. Unplanned pregnancy was an independent risk factor in both rural and peri-urban communities. Interventions around family planning, especially for adolescent girls and young women, are needed to improve early presentation for ANC.

  10. Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda

    Directory of Open Access Journals (Sweden)

    Tugumisirize Joshua

    2010-06-01

    Full Text Available Abstract Background Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented. During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training. Methods The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas. Results Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from

  11. Migration in Afro-Brazilian rural communities: crossing demographic and genetic data.

    Science.gov (United States)

    Amorim, Carlos Eduardo G; Gontijo, Carolina C; Falcão-Alencar, Gabriel; Godinho, Neide M O; Toledo, Rafaela C P; Pedrosa, Maria Angélica F; Luizon, Marcelo R; Simões, Aguinaldo L; Klautau-Guimãres, Maria N; Oliveira, Silviene F

    2011-08-01

    Many studies have used genetic markers to understand global migration patterns of our species. However, there are only few studies of human migration on a local scale. We, therefore, researched migration dynamics in three Afro-Brazilian rural communities, using demographic data and ten Ancestry Informative Markers. In addition to the description of migration and marriage structures, we carried out genetic comparisons between the three populations, as well as between locals and migrants from each community. Genetic admixture analyses were conducted according to the gene-identity method, with Sub-Saharan Africans, Amerindians, and Europeans as parental populations. The three analyzed Afro-Brazilian rural communities consisted of 16% to 30% of migrants, most of them women. The age pyramid revealed a gap in the segment of men aged between 20 to 30 yrs. While endogamous marriages predominated, exogamous marriages were mainly patrilocal. Migration dynamics are apparently associated with matrimonial customs and other social practices of such communities. The impact of migration upon the populations' genetic composition was low but showed an increase in European alleles with a concomitant decrease in the Amerindian contribution. Admixture analysis evidenced a higher African contribution to the gene pool of the studied populations, followed by the contribution of Europeans and Amerindians, respectively.

  12. Place Identity, Participation, and Emotional Climate in a Rural Community From the Northern Coast of Peru.

    Science.gov (United States)

    Freire, Silvana; Espinosa, Agustín; Rottenbacher, Jan Marc

    2015-01-01

    Currently, in rural communities from the Peruvian northern coast, it is common to find a climate of distrust and pessimism that accompanies the lack of coordinated social action and community participation among residents. This study analyzes the relationships that people develop with regard to the place where they live in, how it associates to the ways they participate in their community and the relationship that these two variables have with the perceived emotional climate, in a rural community from the northern coast of Peru (n = 81). Results indicate that place identity is significantly associated with a high community participation and a climate of trust in the community. Finally, a Path Analysis is performed to analyze comprehensively the relationship between these variables. The results suggest that place identity does have an influence on perceived positive climate in the community, being mediated by the dimensions of community participation.

  13. Creation of a mobile rural workforce following undergraduate longitudinal rural immersion.

    Science.gov (United States)

    Playford, Denese E; Ng, Wen Qi; Burkitt, Tessa

    2016-05-01

    This study followed the workforce choices of 10-years of graduates from a longitudinal rural immersion programme, which involved living for one academic year in a rural location as a medical student. The Rural Clinical School of Western Australia is a whole-of-state Rural Clinical School partnership involving two medical schools and fourteen rural/remote towns. For this longitudinal cohort study, all consenting graduates were contacted annually after graduation, with the outcome measure being rural work location (defined by the Australian Standard Geographical Classification -Remoteness Area) of any duration. There were 417 consenting graduates. Between 16 and 50% of contacted alumni worked rurally for a period of each post-graduate year. Aggregated over time, the majority took up to 30% of their postgraduate training rurally. There was considerable movement in and out of rural work. About 17% of contacted and practicing graduates were working full time rurally at the 2013 contact point. The majority remained in their state of training. The majority identified with GP and other rural-related colleges, and College-affiliation predicted amount of rural training time. Entry into rural work was equivalent for urban-origin and rural origin alumni, suggesting one year of RCS is sufficient to convert commitment to rural work. Undergraduate rural immersion is sufficient to create a graduate rural workforce that is far more mobile that was previously appreciated.

  14. Program of active aging in a rural Mexican community: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Mendoza-Núñez Víctor

    2007-10-01

    Full Text Available Abstract Background Education is one of the key elements in the promotion of a thorough paradigm for active aging. The aim of this study is to analyze factors that contribute the empowerment of older adults in a rural Mexican community and, thus, promote active aging. Methods The study was conducted in a rural Mexican community (Valle del Mezquital, based on an action-research paradigm. One hundred and fifty-five elderly subjects with elementary school education participated in a formal training program promoting gerontological development and health education. Participants in turn became coordinators of mutual-help groups (gerontological nucleus in Mexico. In-depth interviews were carried out to assess the empowerment after training for active aging. Results It was found that there was an increasing feeling of empowerment, creativity and self-fulfillment among participants. Among the main factors that positively influenced training of the elderly toward active aging were the teaching of gerontology topics themselves; besides, their motivation, the self-esteem, the increased undertaking of responsibility, the feeling of belonging to the group, and the sharing of information based on personal experience and on gerontological knowledge. Conclusion The main factors that contribute to empowerment of older adults in a rural Mexican community for participate in active aging programs are the training and teaching of gerontology topics themselves; besides, their interest, experience and involvement.

  15. Program of active aging in a rural Mexican community: a qualitative approach.

    Science.gov (United States)

    de la Luz Martínez-Maldonado, María; Correa-Muñoz, Elsa; Mendoza-Núñez, Víctor Manuel

    2007-10-03

    Education is one of the key elements in the promotion of a thorough paradigm for active aging. The aim of this study is to analyze factors that contribute the empowerment of older adults in a rural Mexican community and, thus, promote active aging. The study was conducted in a rural Mexican community (Valle del Mezquital), based on an action-research paradigm. One hundred and fifty-five elderly subjects with elementary school education participated in a formal training program promoting gerontological development and health education. Participants in turn became coordinators of mutual-help groups (gerontological nucleus) in Mexico. In-depth interviews were carried out to assess the empowerment after training for active aging. It was found that there was an increasing feeling of empowerment, creativity and self-fulfillment among participants. Among the main factors that positively influenced training of the elderly toward active aging were the teaching of gerontology topics themselves; besides, their motivation, the self-esteem, the increased undertaking of responsibility, the feeling of belonging to the group, and the sharing of information based on personal experience and on gerontological knowledge. The main factors that contribute to empowerment of older adults in a rural Mexican community for participate in active aging programs are the training and teaching of gerontology topics themselves; besides, their interest, experience and involvement.

  16. Can E- Commerce Enable Marketing in an African Rural Women's Community Based Development Organization?

    Directory of Open Access Journals (Sweden)

    Jo Rhodes

    2003-01-01

    Full Text Available It is suggested by various sources (Worldbank, 2000; Cypher, 1997 that investment in infrastructure and modern technologies such as ITC's may break down some of the barriers of access such as physical remoteness for poor rural communities. However there is little existing research that examines this sce-nario at the micro level. This paper uses a case study- the Rural Women's Association (RWA of Sek-huhkuneland, Northern Province, South Africa to examine if E- commerce can enable access to markets in an impoverished, under resourced rural location. This paper has five parts: Part 1 consists of the background and rationale for this study, Part 2 focuses on the education, business acumen and gender issues. Part 3 discusses the current market environment. Part 4 discusses possible business models that can integrate e-commerce in its implementation. Part 5 provides the research questions and the method-ology for this study. The final discussion in this study provides us with a viable e-commerce model that could be used in a rural setting and could provide greater economic development for this community.

  17. Community Leadership in Rural Tourism Development: A Tale of Two Ancient Chinese Villages

    Directory of Open Access Journals (Sweden)

    Keshuai Xu

    2017-12-01

    Full Text Available Researchers are paying increasing attention to questions of community leadership and rural tourism development. Based on leadership theories and the literature on community leadership and tourism development, this study developed a framework for community leadership in rural tourism development and used it to examine two ancient Chinese villages. We used the longitudinal case study method to collect data, and we used textual analysis to analyze these data. The results show that the rebel leadership characteristic of confrontational actions played an important role in starting the tourism industry in both villages. However, this leadership was difficult to maintain because community leaders and residents had limited power compared to that of outsiders. Losing control of tourism development in the two villages led to banal management, which prevented the emergence of strong community leadership. In the future, we argue that resilient community leadership should be nurtured in the two villages to address more complex problems occurring in tourism development, such as those characterized by vision tensions and conflicts of interest among the stakeholders affected by tourism development. Finally, we suggest that, based on the longitudinal method, future research can focus on the relationship between resilient leadership and the resilience of tourism communities.

  18. Early Career Leadership Opportunities in Australian Rural Schools

    Science.gov (United States)

    Graham, Lorraine; Miller, Judith; Paterson, David

    2009-01-01

    Due to the difficulties inherent in staffing rural schools in Australia, it is increasingly common for beginning teachers to fill school leadership roles early in their careers. The purpose of this paper is to explore the accelerated progression of some early career teachers who have been offered leadership opportunities in rural schools. Results…

  19. Rural Student Entrepreneurs: Linking Commerce and Community. (Benefits)[Squared]: The Exponential Results of Linking School Improvement and Community Development, Issue Number Three.

    Science.gov (United States)

    Boethel, Martha

    In many rural areas, both communities and schools are threatened by decreasing population and changing economic conditions. To boost both the local economy and student achievement, a growing number of rural schools are turning to entrepreneurial education. In school entrepreneurship programs, students create small businesses under the guidance of…

  20. Child gender preferences in an urban and rural community in Enugu ...

    African Journals Online (AJOL)

    Conclusion: Son preference exists in the rural and urban community in Enugu State however a balanced preference is also common especially in the urban area. Recommendation: Family education especially on gender equality and sensitivity was recommended. Keywords: Son preference, balanced preference, Urban, ...

  1. Child-Caregiver Interaction in Two Remote Indigenous Australian Communities

    Directory of Open Access Journals (Sweden)

    Jill eVaughan

    2015-04-01

    Full Text Available This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu respectively to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English respectively. The study focuses on language input from primary caregivers to a group of preschool children, and on the children’s productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately two years apart, to explore changes in adult input over time and developmental patterns in the children’s speech.At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT, there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio. For measures of morphosyntactic complexity (MLU, children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study’s findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children’s language and linguistic input varies diachronically across time. As

  2. Does Place Attachment Predict Wildfire Mitigation and Preparedness? A Comparison of Wildland-Urban Interface and Rural Communities.

    Science.gov (United States)

    Anton, Charis E; Lawrence, Carmen

    2016-01-01

    Wildfires are a common occurrence in many countries and are predicted to increase as we experience the effects of climate change. As more people are expected to be affected by fires, it is important to increase people's wildfire mitigation and preparation. Place attachment has been theorized to be related to mitigation and preparation. The present study examined place attachment and wildfire mitigation and preparation in two Australian samples, one rural and one on the wildland-urban interface. The study consisted of 300 participants who responded to questionnaires about their place attachment to their homes and local areas, as well as describing their socio-demographic characteristics and wildfire mitigation and preparedness. Hierarchical regression showed that place attachment to homes predicted wildfire mitigation and preparedness in the rural sample but not in the wildland-urban interface sample. The results suggest that place attachment is a motivator for mitigation and preparation only for people living rurally. Reminding rural residents of their attachment to home at the beginning of wildfire season may result in greater mitigation and preparedness. Further research focusing on why attachment does not predict mitigation and preparedness in the wildland-urban interface is needed.

  3. Developing an agenda for research about policies to improve access to healthy foods in rural communities: a concept mapping study

    Science.gov (United States)

    2014-01-01

    Background Policies that improve access to healthy, affordable foods may improve population health and reduce health disparities. In the United States most food access policy research focuses on urban communities even though residents of rural communities face disproportionately higher risk for nutrition-related chronic diseases compared to residents of urban communities. The purpose of this study was to (1) identify the factors associated with access to healthy, affordable food in rural communities in the United States; and (2) prioritize a meaningful and feasible rural food policy research agenda. Methods This study was conducted by the Rural Food Access Workgroup (RFAWG), a workgroup facilitated by the Nutrition and Obesity Policy Research and Evaluation Network. A national sample of academic and non-academic researchers, public health and cooperative extension practitioners, and other experts who focus on rural food access and economic development was invited to complete a concept mapping process that included brainstorming the factors that are associated with rural food access, sorting and organizing the factors into similar domains, and rating the importance of policies and research to address these factors. As a last step, RFAWG members convened to interpret the data and establish research recommendations. Results Seventy-five participants in the brainstorming exercise represented the following sectors: non-extension research (n = 27), non-extension program administration (n = 18), “other” (n = 14), policy advocacy (n = 10), and cooperative extension service (n = 6). The brainstorming exercise generated 90 distinct statements about factors associated with rural food access in the United States; these were sorted into 5 clusters. Go Zones were established for the factors that were rated highly as both a priority policy target and a priority for research. The highest ranked policy and research priorities include strategies designed to

  4. Nutrition-related policy and environmental strategies to prevent obesity in rural communities: a systematic review of the literature, 2002-2013.

    Science.gov (United States)

    Calancie, Larissa; Leeman, Jennifer; Jilcott Pitts, Stephanie B; Khan, Laura Kettel; Fleischhacker, Sheila; Evenson, Kelly R; Schreiner, Michelle; Byker, Carmen; Owens, Clint; McGuirt, Jared; Barnidge, Ellen; Dean, Wesley; Johnson, Donna; Kolodinsky, Jane; Piltch, Emily; Pinard, Courtney; Quinn, Emilee; Whetstone, Lauren; Ammerman, Alice

    2015-04-30

    Residents of rural communities in the United States are at higher risk for obesity than their urban and suburban counterparts. Policy and environmental-change strategies supporting healthier dietary intake can prevent obesity and promote health equity. Evidence in support of these strategies is based largely on urban and suburban studies; little is known about use of these strategies in rural communities. The purpose of this review was to synthesize available evidence on the adaptation, implementation, and effectiveness of policy and environmental obesity-prevention strategies in rural settings. The review was guided by a list of Centers for Disease Control and Prevention Recommended Community Strategies and Measurements to Prevent Obesity in the United States, commonly known as the "COCOMO" strategies. We searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Public Affairs Information Service, and Cochrane databases for articles published from 2002 through 2013 that reported findings from research on nutrition-related policy and environmental strategies in rural communities in the United States and Canada. Two researchers independently abstracted data from each article, and resolved discrepancies by consensus. Of the 663 articles retrieved, 33 met inclusion criteria. The interventions most commonly focused on increasing access to more nutritious foods and beverages or decreasing access to less nutritious options. Rural adaptations included accommodating distance to food sources, tailoring to local food cultures, and building community partnerships. Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities.

  5. Building the Capacity of States to Ensure Inclusion of Rural Communities in State and Local Primary Violence Prevention Planning

    Science.gov (United States)

    Cook-Craig, Patricia G.; Lane, Karen G.; Siebold, Wendi L.

    2010-01-01

    Rural, frontier, and geographically isolated communities face unique challenges associated with ensuring that they are equal partners in capacity-building and prevention planning processes at the state and local level despite barriers that can inhibit participation. By their nature, rural, frontier, and geographically isolated communities and…

  6. A systematic review of published interventions for primary and secondary prevention of ischaemic heart disease (IHD in rural populations of Australia

    Directory of Open Access Journals (Sweden)

    Laura V. Alston

    2016-08-01

    Full Text Available Abstract Background Rural Australians are known to experience a higher burden of ischaemic heart disease (IHD than their metropolitan counterparts and the reasons for this appear to be highly complex and not well understood. It is not clear what interventions and prevention efforts have occurred specifically in rural Australia in terms of IHD. A summary of this evidence could have implications for future action and research in improving the health of rural communities. The aim of this study was to review all published interventions conducted in rural Australia that were aimed at the primary and/or secondary prevention of ischaemic heart disease (IHD in adults. Methods Systematic review of the peer-reviewed literature published between January 1990 and December 2015. Search terms were derived from four major topics: (1 rural; (2 ischaemic heart disease; (3 Australia and; (4 intervention/prevention. Terms were adapted for six databases and three independent researchers screened results. Studies were included if the published work described an intervention focussed on the prevention or reduction of IHD or risk factors, specifically in a rural population of Australia, with outcomes specific to participants including, but not limited to, changes in diet, exercise, cholesterol or blood pressure levels. Results Of 791 papers identified in the search, seven studies met the inclusion criteria, and one further study was retrieved from searching reference lists of screened abstracts. Typically, excluded studies focused on cardiovascular diseases without specific reference to IHD, or presented intervention results without stratification by rurality. Larger trials that included metropolitan residents without stratification were excluded due to differences in the specific needs, characteristics and health service access challenges of rural populations. Six interventions were primary prevention studies, one was secondary prevention only and one included both

  7. The Geography of Rape: Rape Victims in Urban and Rural Communities

    DEFF Research Database (Denmark)

    Nielsen, Louise Hjort

    Little is known from research about barriers to seeking and receiving help following domestic violence, rape, attempted rape, and sexual assault in Denmark. This study examined possible regional differences in reporting rape and sexual assault in urban and rural communities in a large region...

  8. Reducing disaster risk in rural Arctic communities through effective communication strategies

    Science.gov (United States)

    Kontar, Y. Y.

    2015-12-01

    Communication is the process of exchanging and relaying vital information that has bearing on the effectiveness of all phases of emergency management: mitigation, preparedness, response, and recovery, making it one of the most important activities in disasters. Lack of communication between emergency managers, policy makers, and communities at risk may result in an inability to accurately identify disaster risk, and failure to determine priorities during a hazard event. Specific goals of communication change during the four phases of emergency management. Consequently, the communication strategy changes as well. Communication strategy also depends on a variety of attitudinal and motivational characteristics of the population at risk, as well as socioeconomic, cultural, and geographical features of the disaster-prone region. In May 2013, insufficient communication patterns between federal, state, tribal agencies, and affected communities significantly contributed to delays in the flood response and recovery in several rural villages along the Yukon River in central Alaska. This case study finds that long term dialogue is critical for managing disaster risk and increasing disaster resilience in rural Northern communities. It introduces new ideas and highlights best practices in disaster communication.

  9. A Comparison of Didactic and Inquiry Teaching Methods in a Rural Community College Earth Science Course

    Science.gov (United States)

    Beam, Margery Elizabeth

    The combination of increasing enrollment and the importance of providing transfer students a solid foundation in science calls for science faculty to evaluate teaching methods in rural community colleges. The purpose of this study was to examine and compare the effectiveness of two teaching methods, inquiry teaching methods and didactic teaching methods, applied in a rural community college earth science course. Two groups of students were taught the same content via inquiry and didactic teaching methods. Analysis of quantitative data included a non-parametric ranking statistical testing method in which the difference between the rankings and the median of the post-test scores was analyzed for significance. Results indicated there was not a significant statistical difference between the teaching methods for the group of students participating in the research. The practical and educational significance of this study provides valuable perspectives on teaching methods and student learning styles in rural community colleges.

  10. Conversations on telemental health: listening to remote and rural First Nations communities.

    Science.gov (United States)

    Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

    2011-01-01

    Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward

  11. Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience1

    Science.gov (United States)

    Bierman, Karen L.

    2012-01-01

    Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program. PMID:9338956

  12. Networking the rural community.

    Science.gov (United States)

    Tiongson, K H; Arneson, S I

    1993-04-01

    A branch network of affiliate hospitals has been providing home care services to rural North Dakota residents successfully for a decade. Here's how this effective system meets the special challenges that a rural environment poses for hiring, training, scheduling, and supporting home care aides.

  13. Psychiatric treatment of children and adolescents in rural communities. Myths and realities.

    Science.gov (United States)

    Cook, A D; Copans, S A; Schetky, D H

    1998-07-01

    Rural child and adolescent psychiatry offers many challenges, a varied and interesting practice, and the satisfaction of performing needed and important work in an environment in which one's presence is valued. The successful psychiatrist can expect to be an integrated and appreciated member of the community. The fit is not a good one for every practitioner, however. Not only are incomes lower, although the cost of living is low as well, but practitioners may find they have only exchanged urban stresses for rural pressures. The characteristics important for the child and adolescent psychiatrist are the same for rural and urban settings: flexibility, creativity and innovation, competence, self confidence, a good sense of boundaries, a good balance between personal and private life, supportive personal relationships, and a sense of humor. One must be a child advocate, have a willingness to give of one's self and one's time, and be down to earth, comfortable with oneself, and capable of self entertainment. Training programs with access to rural populations can introduce residents to rural child and adolescent psychiatry while supporting those who are already in practice. The authors hope that this article will promote a dialogue with psychiatrists considering relocation to a rural area and encourage training programs to prepare residents for rural practice.

  14. Community as classroom: teaching and learning public health in rural Appalachia.

    Science.gov (United States)

    Florence, James; Behringer, Bruce

    2011-01-01

    Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the

  15. Gender differentiation in community responses to AIDS in rural Uganda.

    Science.gov (United States)

    Kanyamurwa, J M; Ampek, G T

    2007-01-01

    AIDS has been reported in Africa to push households into poverty and chronic food insecurity. At the same time there are reports of significant household resilience to AIDS. This study explored how a mature epidemic in rural Uganda has affected rural farming households. It focused on gender differences in the experience of AIDS and, in particular, household capabilities to sustain livelihoods. The study compared the vulnerability of male- and female-headed households in relation to their ability to mitigate human resource losses, as well as their access to natural and physical resources, to social networks and to finance capital for production. The findings suggest that when rural households are affected by AIDS, depleting productive resources and directing resources towards immediate needs, there are gender differences in responses to, and in impacts of, the epidemic due to the different resources available to male- and female- headed households. Female-headed households were found to be more vulnerable to AIDS than male-headed counterparts. Women's remarriage opportunities were lower than men's, they faced greater risk of losing control over land and livestock and they accessed less state and private sector support. Women-headed households were more dependent on livelihood support from non-governmental organizations, which were found to provide both welfare and credit support to female-headed households affected by AIDS. Women were found to play an important role in social networks and resources at community level but themselves received little support from many formal community networks and services.

  16. The College Transition for First-Year Students from Rural Oregon Communities

    Science.gov (United States)

    Ganss, Karen M.

    2016-01-01

    This study explores the lived experiences of 10 students entering college from rural Oregon communities. Using narrative inquiry, the author examines students' transition, common experiences, and enrollment barriers. Resulting themes include: (a) unexpected emotional and social transition, (b) motivations for enrolling, (c) lack of social and…

  17. ECOLOGICAL ETHICS. VALUES AND NORMS IN LOCAL RURAL COMMUNITIES

    OpenAIRE

    Włodzimierz Kaczocha; Jan Sikora

    2016-01-01

    An important role in sustainable rural development, involving economy, local communities and nature, should be played by ethics. This paper presents a theoretical and empirical characterization of basic problems of ecological ethics. First and foremost, the study characterizes the philosophical fundamentals of this ethics, with emphasis on ontological and anthropological views of selected thinkers. A universal concept of ecological ethics was proposed, containing values and moral norms that p...

  18. Local responses to global technological change – Contrasting restructuring practices in two rural communities in Austria.

    NARCIS (Netherlands)

    Fink, M.; Lang, R..; Harms, Rainer

    2013-01-01

    In this article, we investigate into local economic restructuring in rural areas that are affected by disruptive technologies. Drawing on an institutionalist framework we apply systematic theory-informed case study analysis of two rural communities in Austria and identify practices that are crucial

  19. Responding to Indigenous Australian Sexual Assault

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    Janya McCalman

    2014-01-01

    Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.

  20. Making it Work 2: using a virtual community to focus on rural health issues.

    Science.gov (United States)

    Godden, David J; Aaraas, Ivar J

    2006-01-01

    Between 21 and 23 September 2005, over 200 delegates from eight countries gathered in Tromsö, within the Arctic Circle, to discuss challenges and solutions to rural health issues. This conference was a sequel to a previous event entitled 'Making it Work', held in Scotland in 2003, in which it was identified that service delivery in remote and rural areas needed to be innovative to ensure equity. A major aim of this event was to move the debate forward to describe specific examples of practice that could be adopted in participating countries. The delegates included clinicians, managers and administrators, senior policymakers and educationalists, elected local and national politicians, patients and their representatives. In order to focus debate, the organisers provided an outline of a virtual remote community ('Hope'), including some geographic and demographic information, together with four case studies of individual health problems faced by residents of the community. During the introductory session, a short film was shown featuring the 'residents' of this community, introducing delegates to the specific problems they faced. Throughout the conference, delegates were asked to reflect back to how any recommendations made might apply to the citizens of Hope. The clinical scenarios presented included: (1) a 37 year old pregnant woman in labour during adverse weather conditions; (2) a 17 year old island resident with acute psychosis who attempts suicide; (3) an 80 year old woman living alone who suffers a stroke; and (4) a family of four with a complex range of chronic health issues including smoking, alcoholism, diabetes, teenage pregnancy, asthma and depression on a background of deprivation and unemployment. Parallel discussions and workshops focussed on a number of key themes linked to the examples highlighted in the 'Hope' scenario. These included: maternity services; mental health; chronic disease management; health improvement and illness prevention; supporting

  1. Mental health, well-being, and poverty: A study in urban and rural communities in Northeastern Brazil.

    Science.gov (United States)

    Nepomuceno, Bárbara Barbosa; Cardoso, Antonio Alan Vieira; Ximenes, Verônica Morais; Barros, João Paulo Pereira; Leite, Jáder Ferreira

    2016-01-01

    This article analyzes the relations between mental health and well-being in urban and rural contexts marked by poverty. The analysis takes as its basis a quantitative research conducted with 417 adult inhabitants of two communities, one rural and the other urban, in Northeastern Brazil. The data were constructed using questionnaires composed of sociodemographic data, the Personal Wellbeing Index and Self Report Questionnaire (SRQ-20) scales. We found significant differences between the inhabitants of the rural and urban communities regarding well-being and the prevalence of common mental disorders (CMD), with a higher average well-being score in the rural context; the urban sample had a higher average regarding the prevalence of CMD. The variable income significantly influenced the SRQ-20 average scores; the same was not observed with well-being scores. Besides, it was observed that there is a negative correlation with well-being and CMD.

  2. Building resilience to food insecurity in rural communities: Evidence from traditional institutions in Zimbabwe

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    Emmanuel Mavhura

    2017-06-01

    Full Text Available Many rural communities that depend on smallholder farming face food insecurity induced by climate-related disasters. In response, some communities are taking the initiative to cope and adapt to climate-related disasters. Using case study material from the Zambezi Valley, Zimbabwe, this article examines how traditional institutions are enhancing resilience to food insecurity in rural areas. The data were collected through interviews and focus groups involving traditional leaders, ward councillors, village civil protection members and villagers selected in the valley. The findings point to how the Zunde raMambo informal safety net, nhimbe form of collective work and the practice of share-rearing arrangement to access draught power help save lives and alleviate food insecurity induced by flood or drought disasters. The study concludes that the three schemes are evidence of community reorganisation or change in response to food insecurity. They are a form of absorptive capacities enabling the community to cope with food insecurity.

  3. Differentiated surface fungal communities at point of harvest on apple fruits from rural and peri-urban orchards.

    Science.gov (United States)

    Shen, Youming; Nie, Jiyun; Li, Zhixia; Li, Haifei; Wu, Yonglong; Dong, Yafeng; Zhang, Jianyi

    2018-02-01

    The diverse fungal communities that colonize fruit surfaces are closely associated with fruit development, preservation and quality control. However, the overall fungi adhering to the fruit surface and the inference of environmental factors are still unknown. Here, we characterized the fungal signatures on apple surfaces by sequencing internal transcribed spacer 1 (ITS1) region. We collected the surface fungal communities from apple fruits cultivated in rural and peri-urban orchards. A total of 111 fungal genera belonging to 4 phyla were identified, showing remarkable fungal diversity on the apple surface. Comparative analysis of rural samples harboured higher fungal diversity than those from peri-urban orchards. In addition, fungal composition varied significantly across apple samples. At the genus level, the protective genera Coniothyrium, Paraphaeosphaeria and Periconia were enriched in rural samples. The pathogenic genera Acremonium, Aspergillus, Penicillium and Tilletiposis were enriched in peri-urban samples. Our findings indicate that rural samples maintained more diverse fungal communities on apple surfaces, whereas peri-urban-planted apple carried potential pathogenic risks. This study sheds light on ways to improve fruit cultivation and disease prevention practices.

  4. Re-imagining occupational therapy clients as communities: Presenting the community-centred practice framework.

    Science.gov (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2018-01-09

    Occupational therapists' are increasingly working with communities and providing services at the community level. There is, however, a lack of conceptual frameworks to guide this work. The aim of this article is to present a new conceptual framework for community-centered practice in occupational therapy. The conceptual framework was developed from qualitative multi-case research on exemplars of community participation. The first was, a network of Canadian food security programs, and the second, a rural Australian community banking initiative. Key themes were identified from across the case studies, and cross-case findings interpreted using occupational therapy and occupational science knowledge, and relevant social theory. The outcome is a four-stage, occupation-focused, community-centered practice framework. The Community-Centred Practice Framework can be used by occupational therapists to understand and apply a community-centered practice approach. The four stages are: (1) Community Identity, (2) Community Occupations, (3) Community Resources and Barriers, and (4) Participation Enablement. Further research is needed to trial and critically evaluate the framework, to assess its usefulness as a robust, occupation-focused, frame of reference to guide community-centered practice in occupational therapy. The proposed framework should assist occupational therapists to conceptualize community-centered practice, and to utilize and apply theory.

  5. Evidence for low high-density lipoprotein cholesterol levels in Australian indigenous peoples: a systematic review.

    Science.gov (United States)

    Lyons, Jasmine G; O'Dea, Kerin; Walker, Karen Z

    2014-06-02

    Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia's Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C. PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: Indigenous populations living in rural and remote communities. Inverse associations between HDL-C and central obesity, diabetes prevalence and inflammatory markers suggest a particularly adverse CVD risk factor profile. An absence of sex dichotomy in HDL-C levels warrants further investigation.

  6. SEX PREFERENCESAMONG RURAL COMMUNITY: PUBLIC HEALTH AND SOCIAL CONCERN

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    Aalok Kumar Singh, Sunil Thitame, Reecha Ghimire

    2015-04-01

    Full Text Available Background: Sex preference is choice of selecting the sex of children by their parents or family members. The objective of the study was to study the existence of sex preference among rural community. Material and methods: A Cross-sectional study was carried out among 200 ever married women of reproductive age group. Random digits sampling method was used to select 10 villages in Rahata Tehsil of Ahmednagar, while systematic sampling was applied for selection of 20 samples in each village. Results: In the previous sex preference for male child was 37.3%, 58.75%, 88.5%, 100% and 100% from firstchild to fifth respectively, while female preference and either sexpreference was decreasing. In the current sex preference for male, female and either was 36.8%, 25% and 38.2% respectively. Future sex preference was 40.9% for male child, 22.7% for female child and 36.4% for either sex. The main reason for son preference was for old age care and support, to continue the family name and earning member in the family. Conclusion: Study confirms that son preference still existsin the rural community of Maharashtra. Attitude for son preference is mainly because of the economic earning, old age care and continuation of the family nameamong all groups.

  7. "Make My Day, Shoot a Teacher": Tactics of Inclusion and Exclusion, and the Contestation of Community in a Rural School-Community Conflict

    Science.gov (United States)

    McHenry-Sorber, Erin; Schafft, Kai A.

    2015-01-01

    Far from being the harmonious and homogenous communities of popular imagination, rural communities often are characterised by stark differences in class-situated values over education philosophy and financing. These differences can produce contentious political environments, vastly complexifying local decision-making, including school district…

  8. Reducing psychological distress and obesity in Australian farmers by promoting physical activity

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    McCoombe Scott

    2011-05-01

    Full Text Available Abstract Background Studies have confirmed that the rate of mental illness is no higher in rural Australians than that of urban Australians. However, the rate of poor mental health outcomes, and in particular suicide, is significantly raised in rural populations. This is thought to be due to lack of early diagnosis, health service access, the distance-decay effect, poor physical health determinants and access to firearms. Research conducted by the National Centre for Farmer Health between 2004 and 2009 reveals that there is a correlation between obesity and psychological distress among the farming community where suicide rates are recognised as high. Chronic stress overstimulates the regulation of the hypothalamic-pituitary-adrenal (HPA axis that is associated with abdominal obesity. Increasing physical activity may block negative thoughts, increase social contact, positively influence brain chemistry and improve both physical and mental health. This paper describes the design of the Farming Fit study that aims to identify the effect of physical activity on psychological distress, obesity and health behaviours such as diet patterns and smoking in farm men and women. Methods/Design For this quasi-experimental (convenience sample control-intervention study, overweight (Body Mass Index ≥25 kg/m2 farm men and women will be recruited from Sustainable Farm Families™ (SFF programs held across Victoria, Australia. Baseline demographic data, health data, depression anxiety stress scale (DASS scores, dietary information, physical activity data, anthropometric data, blood pressure and biochemical analysis of plasma and salivary cortisol levels will be collected. The intervention group will receive an exercise program and regular phone coaching in order to increase their physical activity. Analysis will evaluate the impact of the intervention by longitudinal data (baseline and post intervention comparison of intervention and control groups. Discussion

  9. A Community-Supported Clinic-Based Program for Prevention of Violence against Pregnant Women in Rural Kenya

    Directory of Open Access Journals (Sweden)

    Janet M. Turan

    2013-01-01

    Full Text Available Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV. We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya. Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups (n=2 groups and in-depth interviews (n=25 with healthcare workers and community members. Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37% reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting. Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa.

  10. Social entrepreneurship: A foundation for “creative capitalism” in rural African communities

    CSIR Research Space (South Africa)

    van Rensburg, JFJ

    2008-11-01

    Full Text Available The authors wish to share some of their current learning in the creation of social enterprises to act as primary support mechanisms for Infopreneurs (“creative capitalists”) in the rural African communities. The objective is to attract interested...

  11. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2018-02-01

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  12. Attitude about mental illness of health care providers and community leaders in rural Haryana, North India

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    Harshal Ramesh Salve

    2014-12-01

    Full Text Available Background: Attitude about mental illness determines health seeking of the people. Success of National Mental Health Programme (NMHP is dependent on attitude about mental illness of various stakeholders in the programme. Material & Methods: A community based cross-sectional study was carried out in Ballabgarh block of Faridabad district in Haryana. We aimed to study attitude about mental illness of various stakeholders of health care providers (HCP, community leaders in rural area of Haryana, north India. Study area consisting of five Primary Health Centers (PHCs serving 2,12,000 rural population. All HCP working at PHCs, Accredited Social Health Activist (ASHA and community leaders in study area were approached for participation. Hindi version of Opinion about Mental illness Scale for Chinese Community (OMICC was used to study attitude. Results: In total, 467 participants were participated in the study. Of which, HCP, ASHAs and community leaders were 81 (17.4%, 145 (31.0% and 241 (51.6% respectively. Community members reported socially restrictive, pessimistic and stereotyping attitude towards mentally ill person. ASHA and HCP reported stereotyping attitude about person with mental illness. None of the stakeholders reported stigmatizing attitude. Conclusion: Training programme focusing on spectrum of mental illness for HCP and ASHA working in rural area under NMHP programme is needed. Awareness generation of community leaders about bio-medical concept of mental illness is cornerstone of NMHP success in India.

  13. Mapping radioactivity in groundwater to identify elevated exposure in remote and rural communities

    Energy Technology Data Exchange (ETDEWEB)

    Kleinschmidt, Ross, E-mail: ross_kleinschmidt@health.qld.gov.a [Queensland University of Technology, Faculty of Science and Technology, Discipline of Physics, 2 George Street, Brisbane, Queensland 4000 (Australia); Health Physics Unit, Queensland Health Forensic and Scientific Services, 39 Kessels Road, Coopers Plains, Queensland 4108 (Australia); Black, Jeffrey [Health Physics Unit, Queensland Health Forensic and Scientific Services, 39 Kessels Road, Coopers Plains, Queensland 4108 (Australia); Akber, Riaz [Queensland University of Technology, Faculty of Science and Technology, Discipline of Physics, 2 George Street, Brisbane, Queensland 4000 (Australia)

    2011-03-15

    A survey of radioactivity in groundwater (110 sites) was conducted as a precursor to providing a baseline of radiation exposure in rural and remote communities in Queensland, Australia, that may be impacted upon by exposure pathways associated with the supply, treatment, use and wastewater treatment of the resource. Radionuclides in groundwater, including {sup 238}U, {sup 226}Ra, {sup 222}Rn, {sup 228}Ra, {sup 224}Ra and {sup 40}K were measured and found to contain activity concentration levels of up to 0.71 BqL{sup -1}, 0.96 BqL{sup -1}, 108 BqL{sup -1}, 2.8 BqL{sup -1}, 0.11 BqL{sup -1} and 0.19 BqL{sup -1} respectively. Activity concentration results were classified by aquifer lithology, showing correlation between increased radium isotope concentration and basic volcanic host rock. The groundwater survey and mapping results were further assessed using an investigation assessment tool to identify seven remote or rural communities that may require additional radiation dose assessment beyond that attributed to ingestion of potable water. - Research highlights: {yields} We studied the concentration of naturally occurring radioactivity in groundwater in Queensland, Australia. {yields} Groundwater radioactivity concentrations were classified by aquifer type, location and magnitude. {yields} Radioactivity concentration in groundwater was used to develop a tool to determine the potential for elevated radiation exposure to rural and remote communities, based on a case study of a reference site. {yields} Of 110 groundwater bores tested, seven were assessed as requiring further community dose assessment.

  14. Prevalence and risk factors for human toxoplasmosis in a rural community

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    JM Marques

    2008-01-01

    Full Text Available Toxoplasma gondii infection may lead to important pathological questions, especially in rural areas, where several sources of infection exist. Therefore, it is important to determine risk factors in order to establish adequate prophylactic measures. The present study aimed to assess the prevalence and risk factors involved in human toxoplasmosis infection in a rural community, in Eldorado, Mato Grosso do Sul State, Brazil. This community was composed of 185 farms - with 671 inhabitants - from which 20 were randomly chosen. In these farms, blood samples were collected from rural workers, who also answered a risk factor questionnaire. Serum samples were analyzed by means of direct agglutination test for the detection of anti-Toxoplasma gondii antibodies. From 73 samples collected, 79.45% were positive. None of the studied variables was significantly associated with the prevalence of the infection. However, among the individuals who reported eyesight impairments, 94.4% had anti-T. gondii antibodies, compared with 74.0% who did not report eyesight changes (p = 0.0594. Moreover, most individuals in the study (68.20% were older than 18 years and presented 84.44% positivity, compared with 66.67% of positive individuals younger than 18 years old. We were able to conclude that a high prevalence of antibodies did not imply significant associations with the risk factors studied.

  15. Paediatric case mix in a rural clinical school is relevant to future practice.

    Science.gov (United States)

    Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

    2017-11-29

    Exposure to a representative case mix is essential for clinical learning, with logbooks established as a way of demonstrating patient contacts. Few studies have reported the paediatric case mix available to geographically distributed students within the same medical school. Given international interest in expanding medical teaching locations to rural contexts, equitable case exposure in rural relative to urban settings is topical. The Rural Clinical School of Western Australia locates students up to 3500 km from the urban university for an academic year. There is particular need to examine paediatric case mix as a study reported Australian graduates felt unprepared for paediatric rotations. We asked: Does a rural clinical school provide a paediatric case mix relevant to future practice? How does the paediatric case mix as logged by rural students compare with that by urban students? The 3745 logs of 76 urban and 76 rural consenting medical students were categorised by presenting symptoms and compared to the Australian Institute of Health and Welfare (AIHW) database Major Diagnostic Categories (MDCs). Rural and urban students logged core paediatric cases, in similar order, despite the striking difference in geographic locations. The pattern of overall presenting problems closely corresponded to Australian paediatric hospital admissions. Rural students logged 91% of cases in secondary healthcare settings; urban students logged 90% of cases in tertiary settings. The top four presenting problems were ENT/respiratory, gastrointestinal/urogenital, neurodevelopmental and musculoskeletal; these made up 60% of all cases. Rural and urban students logged similar proportions of infants, children and adolescents, with a variety of case morbidity. Rural clinical school students logged a mix of core paediatric cases relevant to illnesses of Australian children admitted to public hospitals, with similar order and pattern by age group to urban students, despite major differences

  16. Exploring the social relations of Roma employability: The case of rural segregated communities in Romania

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    Loreni Elena Baciu

    2016-04-01

    Full Text Available The article reports on a qualitative study of Roma employability in Romania. Being the largest ethnic minority group in Europe, the Roma population is the object of profound marginalization in most of the countries where they reside, by measures such as spatial segregation and exclusion from the formal labour market. This article focuses particularly on the Roma living in rural segregated communities. Inspired by institutional ethnography, the aim is to explore the social organization of rural Roma employability from the standpoint of the Roma themselves. The main obstacles to employment, as they are known and shared by our interviewees, are a lack of available jobs within reach, their own lack of education and a rejection by employers on the grounds of them being Roma. As the analyses show, these obstacles, and the individual’s experiences and knowledge about them, are shaped and maintained by extended translocal relations of administration and governance, thus making the rural Roma dependent on a precarious secondary labour market of low-paid day work for neighbouring farmers. The uncertainty of this work, and the organization and work of everyday life it implies for the people inhabiting these communities, further increases the distance to formal employment. It is this complex set of relations coordinating people’s doings that produce the employability of Roma inhabiting the rural segregated communities.

  17. Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

    Science.gov (United States)

    Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W

    2015-08-29

    The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

  18. The Issue of Poverty in the Urban and Rural Communities in Romania

    Directory of Open Access Journals (Sweden)

    ELISA PARASCHIV

    2008-03-01

    Full Text Available The main objective of this work is to answer questions which are relevant for the process of preparing anti-poverty strategies.The major discrepancy between the rural and urban environment with respect to the aspects mentioned above is one of the main conclusions. However, the residence environment usually represents only one of the dimensions or one of the influential factors of poverty in Romania, without any systematic study of the differences/resemblances between urban and rural poverty. In this respect, the study represents a complementary study for the previous analyses, a synthesis of the existent knowledge of resemblances between urban poverty and rural poverty and, implicitly, of the adequate political instruments for combating each of these aspects. According to the arguments presented by the author, in Romania, poverty is territorially concentrated, at the level of both the communities and the households, from the perspective of consumerism, and rural poverty is the key issue of poverty in Romania.

  19. Examining Key Stakeholder and Community Residents' Understanding of Environmental Influences to Inform Place-Based Interventions to Reduce Obesity in Rural Communities, Kentucky 2015.

    Science.gov (United States)

    Gustafson, Alison; McGladrey, Margaret; Liu, Emily; Peritore, Nicole; Webber, Kelly; Butterworth, Brooke; Vail, Ann

    2017-07-07

    Rural residents report high rates of obesity, physical inactivity, and poor eating habits. The objectives of this study were to (1) use the collective impact model to guide efforts to elicit community members' perceptions of county-specific factors influencing high obesity rates; (2) determine the association between utilization of food retail venues and concern about obesity and healthy eating; and (3) determine community members' utilization of physical activity infrastructure and concern about physical inactivity. The study was conducted in 6 rural counties in Kentucky with adult obesity prevalence rates >40%. Community stakeholders met to assess counties' needs and assets in implementing interventions to reduce obesity in their communities. A random-digit dial survey (n = 756) also was conducted to examine awareness and availability of community resources for healthy eating and physical activity. Stakeholders identified lack of access to fruits and vegetables and poor physical activity infrastructure as contributors to obesity. Reporting moderate and serious concern about obesity and healthy eating was associated with higher odds of shopping at a supercenter compared with those expressing little concern. Reported access to information about physical activity opportunities was associated with higher odds of reporting the availability of safe places for physical activity, sidewalks, and trails compared with those who reported that information was difficult to obtain. This study elicits community-identified barriers to healthy behaviors and provides foundational data to inform future place-based obesity reduction interventions. © 2017 National Rural Health Association.

  20. A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations.

    Science.gov (United States)

    Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D; Tanner, Andrea; Kim, Sei-Hill

    2015-01-01

    Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. Qualitative focus groups/interviews. Rural and urban counties in one southeastern state. Two hundred twelve African-American and white men and women ages 21+. Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.

  1. Understanding Barriers and Facilitators to Healthy Eating and Active Living in Rural Communities

    Directory of Open Access Journals (Sweden)

    Rebecca Seguin

    2014-01-01

    Full Text Available Objective. Studies demonstrate that people’s food and physical activity (PA environments influence behavior, yet research examining this in rural communities is limited. Methods. Focus groups of 8–15 women were conducted in rural communities in seven US states. Questions were designed to identify factors within residents’ food and PA environments they felt helped or hindered them from eating healthfully and being physically active. Results. Participants were aged 30–84 years; mean (SD = 61 (14 (N=95. On average, communities had fewer than 5,000 residents. Limited time, social norms, and distances from or lack of exercise facilities were common PA barriers. Facilitators for PA included social support, dog walking, and availability of affordable facilities. Healthy eating barriers included the perception that healthy foods were too expensive; calorically dense large portion sizes served at family meals; and frequency of eating foods away from home, which were perceived as generally unhealthy. Healthy eating supports included culture/value around local food gathering (e.g., hunting and gardening and preservation (e.g., canning and smoking. Friends and family were frequently identified as key influencers of eating and PA behavior. Conclusions. Targeting both social and built environment factors, particularly those unique to rural locales, may enhance support for healthy eating and PA behavior change interventions.

  2. Four Generations of Women's Educational Experience in a Rural Chinese Community

    Science.gov (United States)

    Huang, Haigen; Placier, Peggy

    2015-01-01

    Our study sought to understand changes in gender inequality in education across four generations of rural Chinese women's educational experiences in a small community in southern China. The 24 interviews and numerous informal conversations with 12 women showed that gender-based favouritism for men and against women undergirded family expectations,…

  3. Leveraging Small-Scale Sport Events: Challenges of Organising, Delivering and Managing Sustainable Outcomes in Rural Communities, the Case of Gorski kotar, Croatia

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    Marko Perić

    2016-12-01

    Full Text Available Sports and events play an important role in local identity building and creating a sense of community that encourages participation and increases social capital. Rural communities are specific areas with special needs and can face challenges and restraints when it comes to event organisation. The purpose of this paper is to identify organisational challenges and analyse the potential to achieving long-term sustainable social and economic outcomes linked to small-scale sports events in rural communities. Organisational challenges of rural communities in terms of organising sport events are examined and discussed using the framework of event leveraging developed by O’Brien and Chalip. This methodology is applied and discussed to a case study focusing on small-scale winter sport events in rural Croatia. Semi-structured interviews with local organisers were conducted in order to collect data on the overall event organisation and management, local coordination, role of community stakeholders and challenges facing strategic planning, with the intent to identify objectives for future events. Results were discussed independently and in the context of the leverage framework, with reflection on its applicability to rural communities as the event organisers. Recommendations are provided based on critical insight from the literature and are oriented on how to streamline the process of organising, delivering and managing of events in remote rural communities. Finally, the idea of inter-community organisation is proposed to ensure long-term social and economic benefits and to address the existing issues of overlapping of stakeholder categories, mixed objectives, distrust among stakeholders and inefficiently used local resources.

  4. The economic feasibility of price discounts to improve diet in Australian Aboriginal remote communities.

    Science.gov (United States)

    Magnus, Anne; Moodie, Marj L; Ferguson, Megan; Cobiac, Linda J; Liberato, Selma C; Brimblecombe, Julie

    2016-04-01

    To estimate the cost-effectiveness of fiscal measures applied in remote community food stores for Aboriginal Australians. Six price discount strategies on fruit, vegetables, diet drinks and water were modelled. Baseline diet was measured as 12 months' actual food sales data in three remote Aboriginal communities. Discount-induced changes in food purchases were based on published price elasticity data while the weight of the daily diet was assumed constant. Dietary change was converted to change in sodium and energy intake, and body mass index (BMI) over a 12-month period. Improved lifetime health outcomes, modelled for the remote population of Aboriginal and Torres Strait Islanders, were converted to disability adjusted life years (DALYs) saved using a proportional multistate lifetable model populated with diet-related disease risks and Aboriginal and Torres Strait Islander rates of disease. While dietary change was small, five of the six price discount strategies were estimated as cost-effective, below a $50,000/DALY threshold. Stakeholders are committed to finding ways to reduce important inequalities in health status between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Price discounts offer potential to improve Aboriginal and Torres Strait Islander health. Verification of these results by trial-based research coupled with consideration of factors important to all stakeholders is needed. © 2015 The Authors.

  5. Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers.

    Science.gov (United States)

    Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha

    2015-08-12

    The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the

  6. Community development: an important way for coordinating development of population and social economy in rural areas of China.

    Science.gov (United States)

    Li, J

    1995-01-01

    This article explains how community development is important to rural socioeconomic development in China. Almost all rural socioeconomic activities occur at the community level. Community development encourages voluntarism and self-development, which contribute to adoption of more modern ideas, morals, and values. Community development stimulates changes that favor decreased childbearing and a high quality of child rearing. The special features of Chinese rural communities are identified as underdevelopment, population pressure and resource degradation, collective entities, greater social cohesion, flexibility, affiliations as government units, and access to other useful community organizations. The development model for communities varied over time from an emphasis on family planning to a focus on women's development, poverty alleviation, or economic development. Well-developed communities focused on social security systems, service networks, or environmental protection. Community development is tied to economic development. The growth of collectives played an important role in community development. Women's active and extensive participation and leadership by other influential persons were important forces in community development. Women served as agents of change. Mass participation is now a key feature of community development. Former communes did not include the same level of voluntarism. Community development directly supports increased incomes for families, which decreases the emphasis on children as a source of income. The economic value of children is reduced when communities provide social security. The greater value placed on males is reduced when women's income is increased. Community development lowers the social value of children by improving people's quality of life and by creating a modern social environment.

  7. Health education: an experience in rural communities of Manabí, Ecuador

    Directory of Open Access Journals (Sweden)

    Noemi Bottasso

    2016-12-01

    Full Text Available Health is a very important issue for every human being. A person with deteriorated health can’t study, work and enjoy thoroughly of his/her life. Right to health is a fundamental right of every human being. Rural marginal zones of region Manabí inhabitants suffer serious difficulties in access of health services, for different reasons. With the objective of improve health access, we realized a training to 14 communities in order to introduce First Aid Kits with essential palliatives medication.As an alternative choice to improve access to health services, we promote an educational training of 14 rural communities, in order to bring in medicine and first-aid kits. The process has made considering the perspective of Participatory action research, Popular Education, Gender and the last, but not the least the perspective of human rights, as first requirement for its development.The educational process successfully concluded with empowerment of 12 Health Promoters and with the respective assignment of first-aid kits. It’s recommended to accomplish others activities to follow the project up, for example: an evaluative study, workshops to review, amplify and update the matters. Finally it would be important to replicate the process in these close communities that was excluded in this first phase. 

  8. Rural Australian women's legal help seeking for intimate partner violence: women intimate partner violence victim survivors' perceptions of criminal justice support services.

    Science.gov (United States)

    Ragusa, Angela T

    2013-03-01

    Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study applies a sociological lens by framing the IPV and legal help-seeking experiences of rural Australian women gained from 36 in-depth face-to-face interviews as socially contextualized interactions. Findings reveal police and court responses reflect broader social inequalities and rurality exacerbates concerns such as anonymity and lack of service. Cultural differences and power imbalances between survivors and formal support providers are manifested to inform future research seeking to improve survivors' willingness to engage and satisfaction with formal services. Finally, the important role police and the criminal justice system play in de-stigmatizing IPV and legitimating its unacceptability is argued a crucial, yet unrecognized, key to social change.

  9. Case study of conservation and community concerns for present and future multiple use of the Great Australian Bight

    Energy Technology Data Exchange (ETDEWEB)

    Flaherty, T. [Marine and Coastal Community Network, Henley Beach, SA (Australia)

    1996-12-31

    As part of the Australian National Strategy for ecologically sustainable development, State and Federal Governments have agreed to cooperate on action under the Ocean Rescue 2000 Program to develop a national representative system of Marine Protected Areas. As a component of this program an area of the Great Australian Bight has been the focus of a proposal for a large area multiple use marine park. Within the context of this workshop, however, the conservation and community considerations extend beyond this proposed area. There is a need for resolution of apparent and real conflict with conservation, fishing, tourism and mining objectives in the development of equitable policies in establishing a marine protected area for the significant region. In this paper current activities in the Great Australian Bight, conservation values and concerns, fisheries and conservation, and fisheries and potential conflict with future petroleum exploitation, are discussed. The marine animals of the area are outlined, and community conservation concerns are detailed. It is concluded that there is an increasing need for States to develop a strategic approach to marine management. The adoption of marine bio-regionalisation methodology to define areas of significant biodiversity, representative marine protected areas and the development of a marine conservation and management strategy can be seen as essential components in the management of the marine environment. (author). refs.

  10. Culture and rural health.

    Science.gov (United States)

    Farmer, Jane; Bourke, Lisa; Taylor, Judy; Marley, Julia V; Reid, John; Bracksley, Stacey; Johnson, Nicole

    2012-10-01

    This paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly - for example, suggesting that there is a rural culture, or narrowly - indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed 'elephant in the room' in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  11. Community Participation and Barriers in Rural Tourism: A Case Study in Kiulu, Sabah

    Directory of Open Access Journals (Sweden)

    Velnisa Paimin N. F.

    2014-01-01

    Full Text Available The paper presents an investigation on local community participation and barriers in rural tourism. It identifies two sides of community participation in tourism as identified by Timothy [5], which are; the benefits point of view and from the decision making process perspective. It also identifies the communities’ barriers in engaging in tourism and uses Tosun’s [18] approach in examining the barriers. A total of eighty-three questionnaire forms were completed by respondents from seven villages in Kiulu, Sabah, Malaysia. Respondents involved in tourism were mainly engaged as river guides, homestay operators and Tagal participants. Their involvement in the decision making process were limited to attending meetings and giving ideas and opinions only. The main barriers to participate in tourism were related to their limited knowledge about tourism, lack of capital, unable to communicate well in English, lack of information about tourism development in Kiulu, and limited incentives or support from the government for tourism development. The findings have significant implication to community participation in tourism especially in rural settings. More efforts should be made to ensure many more communities participate in tourism so as to share the benefits of tourism.

  12. Child-caregiver interaction in two remote Indigenous Australian communities

    Science.gov (United States)

    Vaughan, Jill; Wigglesworth, Gillian; Loakes, Deborah; Disbray, Samantha; Moses, Karin

    2015-01-01

    This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu, respectively) to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English, respectively). The study focuses on language input from primary caregivers to a group of preschool children, and on the children's productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately 2 years apart, to explore changes in adult input over time and developmental patterns in the children's speech. At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT), there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio). For measures of morphosyntactic complexity (MLU), children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study's findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children's language and linguistic input varies diachronically across time. As such, we contribute to

  13. Social and cultural features of cholera and shigellosis in peri-urban and rural communities of Zanzibar

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    Hutubessy Raymond

    2010-11-01

    Full Text Available Abstract Background Responding to the high burden of cholera in developing countries, the WHO now considers vaccination as a supplement to the provision of safe drinking water and improved sanitation in the strategy for cholera control in endemic settings. Cultural concepts of illness affect many aspects of public health. In the first step of a two-step strategy to examine determinants of cholera vaccine acceptance, this study identified social and cultural features of diarrhoeal illness for cholera control in endemic communities. Methods A cultural epidemiological study with locally adapted vignette-based interviews was conducted in two cholera-endemic communities of Zanzibar. A random sample of unaffected peri-urban (n = 179 and rural (n = 177 adults was interviewed to study community ideas of cholera and shigellosis, considering categories of distress, perceived causes, and help-seeking behaviour. Results Cholera was recognised by 88%. Symptoms of dehydration were most prominent in reports at the peri-urban site. Interference with work leading to strain on household finances was frequently emphasised. Dirty environment was the most prominent perceived cause, followed by unsafe drinking water and germ-carrying flies. Causes unrelated to the biomedical basis of cholera were reported more often by rural respondents. Rural women had more difficulty (20% to identify a cause than men (7.1%, p = 0.016. Peri-urban self treatment emphasised rehydration; the rural community preferred herbal treatment and antibiotics. Shigellosis was recognised by 70%. Fewer regarded it as very serious compared with cholera (76% vs. 97%, p Conclusions This study clarified local views of cholera and shigellosis relevant for diarrhoeal disease control in Zanzibar. The finding that rural women were less likely than men to specify causes of cholera suggests more attention to them is required. Better health education is needed for cholera in rural areas and for shigellosis

  14. Increasing Participation of Rural and Regional Students in Higher Education

    Science.gov (United States)

    Fleming, Michele J.; Grace, Diana M.

    2014-01-01

    Regional and rural students in Australia face unique challenges when aspiring to higher education. These challenges reflect systematic disadvantage experienced by rural and regional populations as a whole. In an effort to redress these inequities, and aided by the Australian Government's Higher Education Participation and Partnerships Program…

  15. What is at stake? Exploring the moral experience of stigma with Indian-Australians and Anglo-Australians living with depression.

    Science.gov (United States)

    Brijnath, Bianca; Antoniades, Josefine

    2018-04-01

    This article applies the framework of moral experience to examine the cultural experience of stigma with Indian-Australians and Anglo-Australians living with depression in Melbourne, Australia. To date few studies have examined this dynamic in relation to mental illness and culture, and no studies have applied this framework in a culturally comparative way. Based on 58 in-depth interviews with people with depression recruited from the community, we explicate how stigma modulates what is at stake upon disclosure of depression, participants' lived experience following that disclosure, and how practices of health-seeking become stigmatised. Findings show that the social acceptance of depression jars against participants' experience of living with it. Denialism and fear of disclosure were overwhelming themes to emerge from our analysis with significant cultural differences; the Anglo-Australians disclosed their depression to family and friends and encountered significant resistance about the legitimacy of their illness. In contrast, many Indian-Australians, especially men, did not disclose their illness for fear of a damaged reputation and damaged social relations. For Indian-Australians, social relations in the community were at stake, whereas for Anglo-Australians workplace relations (but not community relations) were at stake. Participants' experiences in these settings also influenced their patterns of health-seeking behaviors and age and inter-generational relationships were important mediators of stigma and social support. These findings illuminate how stigma, culture, and setting are linked and they provide critical information necessary to identify and develop customised strategies to mitigate the harmful effects of stigma in particular cultural groups.

  16. Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Hage Eveline

    2013-01-01

    Full Text Available Abstract Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the

  17. Nutrition-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002–2013

    Science.gov (United States)

    Leeman, Jennifer; Jilcott Pitts, Stephanie B.; Khan, Laura Kettel; Fleischhacker, Sheila; Evenson, Kelly R.; Schreiner, Michelle; Byker, Carmen; Owens, Clint; McGuirt, Jared; Barnidge, Ellen; Dean, Wesley; Johnson, Donna; Kolodinsky, Jane; Piltch, Emily; Pinard, Courtney; Quinn, Emilee; Whetstone, Lauren; Ammerman, Alice

    2015-01-01

    Introduction Residents of rural communities in the United States are at higher risk for obesity than their urban and suburban counterparts. Policy and environmental-change strategies supporting healthier dietary intake can prevent obesity and promote health equity. Evidence in support of these strategies is based largely on urban and suburban studies; little is known about use of these strategies in rural communities. The purpose of this review was to synthesize available evidence on the adaptation, implementation, and effectiveness of policy and environmental obesity-prevention strategies in rural settings. Methods The review was guided by a list of Centers for Disease Control and Prevention Recommended Community Strategies and Measurements to Prevent Obesity in the United States, commonly known as the “COCOMO” strategies. We searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Public Affairs Information Service, and Cochrane databases for articles published from 2002 through 2013 that reported findings from research on nutrition-related policy and environmental strategies in rural communities in the United States and Canada. Two researchers independently abstracted data from each article, and resolved discrepancies by consensus. Results Of the 663 articles retrieved, 33 met inclusion criteria. The interventions most commonly focused on increasing access to more nutritious foods and beverages or decreasing access to less nutritious options. Rural adaptations included accommodating distance to food sources, tailoring to local food cultures, and building community partnerships. Conclusions Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities. PMID:25927605

  18. Perception and Attitude of a Rural Community Regarding Adult Blindness in North Central Nigeria.

    Science.gov (United States)

    Olatunji, Victoria A; Adepoju, Feyi G; Owoeye, Joshua F A

    2015-01-01

    To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.

  19. Adapting participatory design to design information system with rural Ethiopian community

    DEFF Research Database (Denmark)

    Zewge, Amanuel; Dittrich, Yvonne; Bekele, Rahel

    2015-01-01

    Most of the Information and Communication Technology for Development initiatives introduced to communities in developing countries fails to deliver its promises due to the lack of intended beneficiary involvement. Participatory Design assumes to be effective as long as its nature of participations...... and methods are contextualized to a given settings. To this end, we discuss the implication of considering local (rural community) culture of participation practices, and propose a procedure to be followed in the early phases of information system development process. Finally we argue that, such adaption...... could advance the Participatory Action Research methodology....

  20. Why and how do general practitioners teach? An exploration of the motivations and experiences of rural Australian general practitioner supervisors.

    Science.gov (United States)

    Ingham, Gerard; Fry, Jennifer; O'Meara, Peter; Tourle, Vianne

    2015-10-29

    In medical education, a learner-centred approach is recommended. There is also a trend towards workplace-based learning outside of the hospital setting. In Australia, this has resulted in an increased need for General Practitioner (GP) supervisors who are receptive to using adult learning principles in their teaching. Little is known about what motivates Australian GP supervisors and how they currently teach. A qualitative study involving semi-structured interviews with 20 rural GP supervisors who work within one Regional Training Provider region in Australia explored their reasons for being a supervisor and how they performed their role. Data was analysed using a thematic analysis approach. GP supervisors identified both personal and professional benefits in being a supervisor, as well as some benefits for their practice. Supervision fulfilled a perceived broader responsibility to the profession and community, though they felt it had little impact on rural retention of doctors. While financial issues did not provide significant motivation to teach, the increasing financial inequity compared with providing direct patient care might impact negatively on the decision to be or to remain a supervisor in the future. The principal challenge for supervisors was finding time for teaching. Despite this, there was little evidence of supervisors adopting strategies to reduce teaching load. Teaching methods were reported in the majority to be case-based with styles extending from didactic to coach/facilitator. The two-way collegiate relationship with a registrar was valued, with supervisors taking an interest in the registrars beyond their development as a clinician. Supervisors report positively on their teaching and mentoring roles. Recruitment strategies that highlight the personal and professional benefits that supervision offers are needed. Practices need assistance to adopt models of supervision and teaching that will help supervisors productively manage the increasing

  1. Towards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.

    Science.gov (United States)

    Pennington, Pamela Marie; Juárez, José Guillermo; Arrivillaga, Margarita Rivera; De Urioste-Stone, Sandra María; Doktor, Katherine; Bryan, Joe P; Escobar, Clara Yaseli; Cordón-Rosales, Celia

    2017-09-01

    Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9%) pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

  2. Pattern of Eye Diseases in Kaduna State – A rural community ...

    African Journals Online (AJOL)

    Senile cataract and anterior segment eye infection were the two eye diseases most frequently seen in Giwa community. The lack of trachoma seems to indicate that the rural water supplies were relatively clean and safe. The majority of eye problems were age-related, and preventable. Objective: The aim of the study was to ...

  3. Community leaders’ perspectives on facilitators and inhibitors of health promotion among the youth in rural South Africa

    Directory of Open Access Journals (Sweden)

    Lydia Aziato

    Full Text Available Introduction: There are a number of factors that influence health promotion activities among the youth. This study sought to gain a comprehensive understanding of the facilitators and inhibitors of health promotion among the youth from the perspectives of community leaders in a rural setting in South Africa. Methods: The study adopted an exploratory, descriptive and contextual qualitative approach involving community leaders in rural South Africa. Data saturation occurred after individual interviews with 21 participants. Data analysis employed the principles of content analysis. Results: We found that facilitators of health promotion were access to education on the benefits of health promotion activities, efforts of organizations and community leaders/teachers, access to health care services and engaging in physical activities, and youth motivation and positive role modelling. The themes that described the inhibitors of health promotion were inadequate recreational and health facilities and health personnel, the impact of stringent religious doctrines, unemployment, social vices and poor parenting. Conclusion: We concluded that there is the need to implement more engaging activities and opportunities for the youth and parents in rural communities to enhance health promotion. Keywords: Health promotion, Young adults, Qualitative research, Rural community

  4. Leadership in Australian Rural Schools: Bush Track, Fast Track

    Science.gov (United States)

    Graham, Lorraine; Paterson, David; Miller, Judith

    2008-01-01

    Due to the difficulties inherent in staffing rural schools it is increasingly common for beginning teachers to fill school leadership roles early in their careers. The accelerated progression of some teachers impacts on the overall nature of leadership in rural schools and creates unique pathways, generally different from those available to…

  5. Electricity access for geographically disadvantaged rural communities--technology and policy insights

    International Nuclear Information System (INIS)

    Chaurey, Akanksha; Ranganathan, Malini; Mohanty, Parimita

    2004-01-01

    The purpose of this paper is to weigh the issues and options for increasing electricity access in remote and geographically challenged villages in interior Rajasthan, the desertstate in Western India where power sector reforms are currently underway. By first providing an overview of reforms and various electrification policy initiatives in India, the paper then analyzes the specific problems as studied at the grass-roots level with respect to rural electricity access and the use of off-grid renewables. Finally, it discusses interventions that could facilitate access to electricity by suggesting a sequential distributed generation (DG)-based approach, wherein consecutive DG schemes--incorporating the requisite technological, financial, and institutional arrangements--are designed depending on the developmental requirements of the community. In essence, this approach fits under the broader need to understand how the three 'Rs'- rural electrification (the process), power sector reforms (the catalyst), and the use of renewable energy technologies (the means) - could potentially converge to meet the needs of India's rural poor

  6. Electricity access for geographically disadvantaged rural communities--technology and policy insights

    Energy Technology Data Exchange (ETDEWEB)

    Chaurey, Akanksha E-mail: akanksha@teri.res.in; Ranganathan, Malini E-mail: malinir@teri.res.in; Mohanty, Parimita

    2004-10-01

    The purpose of this paper is to weigh the issues and options for increasing electricity access in remote and geographically challenged villages in interior Rajasthan, the desertstate in Western India where power sector reforms are currently underway. By first providing an overview of reforms and various electrification policy initiatives in India, the paper then analyzes the specific problems as studied at the grass-roots level with respect to rural electricity access and the use of off-grid renewables. Finally, it discusses interventions that could facilitate access to electricity by suggesting a sequential distributed generation (DG)-based approach, wherein consecutive DG schemes--incorporating the requisite technological, financial, and institutional arrangements--are designed depending on the developmental requirements of the community. In essence, this approach fits under the broader need to understand how the three 'Rs'- rural electrification (the process), power sector reforms (the catalyst), and the use of renewable energy technologies (the means) - could potentially converge to meet the needs of India's rural poor.

  7. Tailoring a response to youth binge drinking in an Aboriginal Australian community: a grounded theory study.

    Science.gov (United States)

    McCalman, Janya; Tsey, Komla; Bainbridge, Roxanne; Shakeshaft, Anthony; Singleton, Michele; Doran, Christopher

    2013-08-07

    While Aboriginal Australian health providers prioritise identification of local community health needs and strategies, they do not always have the opportunity to access or interpret evidence-based literature to inform health improvement innovations. Research partnerships are therefore important when designing or modifying Aboriginal Australian health improvement initiatives and their evaluation. However, there are few models that outline the pragmatic steps by which research partners negotiate to develop, implement and evaluate community-based initiatives. The objective of this paper is to provide a theoretical model of the tailoring of health improvement initiatives by Aboriginal community-based service providers and partner university researchers. It draws from the case of the Beat da Binge community-initiated youth binge drinking harm reduction project in Yarrabah. A theoretical model was developed using the constructivist grounded theory methods of concurrent sampling, data collection and analysis. Data was obtained from the recordings of reflective Community-Based Participatory Research (CBPR) processes with Aboriginal community partners and young people, and university researchers. CBPR data was supplemented with interviews with theoretically sampled project participants. The transcripts of CBPR recordings and interviews were imported into NVIVO and coded to identify categories and theoretical constructs. The identified categories were then developed into higher order concepts and the relationships between concepts identified until the central purpose of those involved in the project and the core process that facilitated that purpose were identified. The tailored alcohol harm reduction project resulted in clarification of the underlying local determinants of binge drinking, and a shift in the project design from a social marketing awareness campaign (based on short-term events) to a more robust advocacy for youth mentoring into education, employment and

  8. Development of a questionnaire to measure consumers' perceptions of service quality in Australian community pharmacies.

    Science.gov (United States)

    Mirzaei, Ardalan; Carter, Stephen R; Chen, Jenny Yimin; Rittsteuer, Claudia; Schneider, Carl R

    2018-06-11

    Recent changes within community pharmacy have seen a shift towards some pharmacies providing "value-added" services. However, providing high levels of service is resource intensive yet revenues from dispensing are declining. Of significance therefore, is how consumers perceive service quality (SQ). However, at present there are no validated and reliable instruments to measure consumers' perceptions of SQ in Australian community pharmacies. The aim of this study was to build a theory-grounded model of service quality (SQ) in community pharmacies and to create a valid survey instrument to measure consumers' perceptions of service quality. Stage 1 dealt with item generation using theory, prior research and qualitative interviews with pharmacy consumers. Selected items were then subjected to content validity and face validity. Stages 2 and 3 included psychometric testing among English-speaking adult consumers of Australian pharmacies. Exploratory factor analysis was used for item reduction and to explain the domains of SQ. In stage 1, item generation for SQ initially generated 113 items which were then refined, through content and face validity, down to 61 items. In stage 2, after subjecting the questionnaire to psychometric testing on the data from the first pharmacy (n = 374), the use of the primary dimensions of SQ was abandoned leaving 32 items representing 5 domains of SQ. In stage 3, the questionnaire was subject to further testing and item reduction in 3 other pharmacies (n = 320). SQ was best described using 23 items representing 6 domains: 'health and medicines advice', 'relationship quality', 'technical quality', 'environmental quality', 'non-prescription service', and 'health outcomes'. This research presents a theoretically-grounded and robust measurement scale developed for consumer perceptions of SQ in a community pharmacy. Copyright © 2018. Published by Elsevier Inc.

  9. The impact of subsidized low aromatic fuel (LAF) on petrol (gasoline) sniffing in remote Australian indigenous communities.

    Science.gov (United States)

    d'Abbs, Peter; Shaw, Gillian; Field, Emma

    2017-08-17

    Since 2005, the Australian Government has subsidized the production and distribution of Low Aromatic Fuel (LAF) as a deterrent against petrol (gasoline) sniffing in remote Indigenous communities. LAF is used in place of unleaded petrol as a fuel for vehicles and other engines. This paper reports findings from an independent evaluation of the LAF rollout. Forty one Indigenous communities were surveyed between 2010 and 2014, with each community being visited twice at a two yearly interval. Quantitative data on prevalence of petrol sniffing were collected, as well as qualitative data on the acceptability of LAF, evidence of substitution for inhaled petrol with other drugs, and programs such as recreational, training and employment opportunities. Prevalence rates of sniffing per 1000 population for each survey year and community were calculated by dividing the total number of sniffers by the population aged 5-39 years and multiplying by 1000. Between 2011-12 and 2013-14, the total estimated number of people sniffing petrol declined from 289 to 204, a fall of 29.4%. At both times, the median petrol sniffing prevalence rate was lower in communities with LAF than in communities without LAF. In 17 of the 41 communities, comparable data were available over a longer period, commencing in 2005-06. Fifteen of these communities stocked LAF over the entire period. In these communities, the median rate of petrol sniffing declined by 96%, from 141.6 per 1000 population in 2005-06 to 5.5 in 2013-14 (p < 0.05). LAF was widely accepted, although acceptance was often qualified by a belief that LAF harmed engines. Anecdotal reports suggest that the fall in petrol sniffing may have been offset by increased use of cannabis and other drugs, but the relationship is not one of simple cause-and-effect, with evidence that an increase in cannabis use in communities commenced before the LAF rollout began. Provision of services in communities has improved in recent years, but many programs

  10. The prevalence of dental anomalies in an Australian population.

    Science.gov (United States)

    Dang, H Q; Constantine, S; Anderson, P J

    2017-06-01

    The aim of this study was to determine the prevalence of dental anomalies within an Australian paediatric population using panoramic radiographs. This was a prospective review of 1050 panoramic radiographs obtained as part of a school dental screening program in suburban and rural New South Wales, Australia. Fifty-four (5.14%) patients had a dental anomaly present. Agenesis was noted to have occurred 69 times across 45 patients (4.28%), along with seven cases of impaction (0.6%) and three cases of supernumerary teeth (0.28%). Dental anomalies rarely occur in the Australian population, which possesses a wide-ranging multiethnic cohort. Despite their rarity, they can be incidentally discovered so identification and management by dental practitioners are important. © 2016 Australian Dental Association.

  11. Barriers Affecting Physical Activity in Rural Communities: Perceptions of Parents and Children

    Science.gov (United States)

    McWhinney, Sharon; McDonald, Andrea; Dawkins-Moultin, Lenna; Outley, Corliss; McKyer, E. Lisako; Thomas, Audrene

    2011-01-01

    A comprehensive understanding of the barriers inhibiting physical activity among children is critical in the fight against childhood obesity. This qualitative interview study examined parents' and children's perceptions of the barriers to physical activity in rural communities of low socioeconomic status. Parents and children concurred that the…

  12. Empowering the people: Development of an HIV peer education model for low literacy rural communities in India

    Directory of Open Access Journals (Sweden)

    Krupp Karl

    2008-04-01

    Full Text Available Abstract Background Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur (Tamil Nadu, India. Methods From January to December 2005, six non-governmental organizations (NGO's with good community rapport collaborated to build and pilot-test an HIV peer education model for rural communities. The program used participatory methods to train 20 NGO field staff (Outreach Workers, 102 women's self-help group (SHG leaders, and 52 barbers to become peer educators. Cartoon-based educational materials were developed for low-literacy populations to convey simple, comprehensive messages on HIV transmission, prevention, support and care. In addition, street theatre cultural programs highlighted issues related to HIV and stigma in the community. Results The program is estimated to have reached over 30 000 villagers in the district through 2051 interactive HIV awareness programs and one-on-one communication. Outreach workers (OWs and peer educators distributed approximately 62 000 educational materials and 69 000 condoms, and also referred approximately 2844 people for services including voluntary counselling and testing (VCT, care and support for HIV, and diagnosis and treatment of sexually-transmitted infections (STI. At least 118 individuals were newly diagnosed as persons living with HIV (PLHIV; 129 PLHIV were referred to the Government Hospital for Thoracic Medicine (in Tambaram for extra medical support. Focus group discussions indicate that the program was well received in the communities, led to improved health

  13. Physical Activity-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002-2013.

    Science.gov (United States)

    Umstattd Meyer, M Renée; Perry, Cynthia K; Sumrall, Jasmin C; Patterson, Megan S; Walsh, Shana M; Clendennen, Stephanie C; Hooker, Steven P; Evenson, Kelly R; Goins, Karin V; Heinrich, Katie M; O'Hara Tompkins, Nancy; Eyler, Amy A; Jones, Sydney; Tabak, Rachel; Valko, Cheryl

    2016-01-07

    Health disparities exist between rural and urban residents; in particular, rural residents have higher rates of chronic diseases and obesity. Evidence supports the effectiveness of policy and environmental strategies to prevent obesity and promote health equity. In 2009, the Centers for Disease Control and Prevention recommended 24 policy and environmental strategies for use by local communities: the Common Community Measures for Obesity Prevention (COCOMO); 12 strategies focus on physical activity. This review was conducted to synthesize evidence on the implementation, relevance, and effectiveness of physical activity-related policy and environmental strategies for obesity prevention in rural communities. A literature search was conducted in PubMed, PsycINFO, Web of Science, CINHAL, and PAIS databases for articles published from 2002 through May 2013 that reported findings from physical activity-related policy or environmental interventions conducted in the United States or Canada. Each article was extracted independently by 2 researchers. Of 2,002 articles, 30 articles representing 26 distinct studies met inclusion criteria. Schools were the most common setting (n = 18 studies). COCOMO strategies were applied in rural communities in 22 studies; the 2 most common COCOMO strategies were "enhance infrastructure supporting walking" (n = 11) and "increase opportunities for extracurricular physical activity" (n = 9). Most studies (n = 21) applied at least one of 8 non-COCOMO strategies; the most common was increasing physical activity opportunities at school outside of physical education (n = 8). Only 14 studies measured or reported physical activity outcomes (10 studies solely used self-report); 10 reported positive changes. Seven of the 12 COCOMO physical activity-related strategies were successfully implemented in 2 or more studies, suggesting that these 7 strategies are relevant in rural communities and the other 5 might be less applicable in rural communities

  14. Emerging issues on the sustainability of the community based rural water resources management approach in Zimbabwe: A case study of Gwanda District

    Directory of Open Access Journals (Sweden)

    Thulani Dube

    2012-12-01

    Full Text Available Although there is considerable on-going debate about the suitability and sustainability of community based water resources management (CBWRM in Africa as a water provision strategy, evidence shows that this approach has gone a long way in promoting access to clean water amongst rural African communities. CBWRM provides an alternative approach to water provision for rural communities. This paper examines how the strategy has been operationalised in Gwanda District in Zimbabwe. The paper examines the experiences of rural communities in using CBWRM. Data was collected using focus group discussions, key informant in-depth interviews and a survey of 685 households in Gwanda district across five wards. The findings of this study are that 67% of the surveyed rural communities in Gwanda depended on community managed water resources mostly in the form of boreholes and protected wells. High rates of nun-functional sources were reported at 60-70% in most wards. Several system weaknesses were noted in the current CBWRM set-up including a depletion of committee memberships, inadequate community resources, limited agency and government support. This paper makes several recommendations on strengthening the capacity of CBWRM in Zimbabwe and Africa.

  15. Late-life depression in Rural China: do village infrastructure and availability of community resources matter?

    Science.gov (United States)

    Li, Lydia W; Liu, Jinyu; Zhang, Zhenmei; Xu, Hongwei

    2015-07-01

    This study aimed to examine whether physical infrastructure and availability of three types of community resources (old-age income support, healthcare facilities, and elder activity centers) in rural villages are associated with depressive symptoms among older adults in rural China. Data were from the 2011 baseline survey of the Chinese Health and Retirement Longitudinal Study (CHARLS). The sample included 3824 older adults aged 60 years or older residing in 301 rural villages across China. A score of 12 on the 10-item Center for Epidemiologic Studies Depression Scale was used as the cutoff for depressed versus not depressed. Village infrastructure was indicated by an index summing deficiency in six areas: drinking water, fuel, road, sewage, waste management, and toilet facilities. Three dichotomous variables indicated whether income support, healthcare facility, and elder activity center were available in the village. Respondents' demographic characteristics (age, gender, marital status, and living arrangements), health status (chronic conditions and physical disability), and socioeconomic status (education, support from children, health insurance, household luxury items, and housing quality) were covariates. Multilevel logistic regression was conducted. Controlling for individuals' socioeconomic status, health status, and demographic characteristics, village infrastructure deficiency was positively associated with the odds of being depressed among rural older Chinese, whereas the provision of income support and healthcare facilities in rural villages was associated with lower odds. Village infrastructure and availability of community resources matter for depressive symptoms in rural older adults. Improving infrastructure, providing old-age income support, and establishing healthcare facilities in villages could be effective strategies to prevent late-life depression in rural China. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Evaluation of Nutrition and Physical Activity Policies and Practices in Child Care Centers within Rural Communities.

    Science.gov (United States)

    Foster, Jaime S; Contreras, Dawn; Gold, Abby; Keim, Ann; Oscarson, Renee; Peters, Paula; Procter, Sandra; Remig, Valentina; Smathers, Carol; Mobley, Amy R

    2015-10-01

    Although some researchers have examined nutrition and physical activity policies within urban child care centers, little is known about the potentially unique needs of rural communities. Child care centers serving preschool children located within low-income rural communities (n = 29) from seven states (Indiana, Kansas, Michigan, North Dakota, Ohio, South Dakota, and Wisconsin) were assessed to determine current nutrition and physical activity (PA) practices and policies. As part of a large-scale childhood obesity prevention project, the Community Healthy Living Index's previously validated Early Childhood Program Assessment Tool was used to collect data. Descriptive statistical analysis was conducted to identify high-priority areas. Healthy People 2020 and the Academy of Nutrition and Dietetics' recommendations for nutrition and PA policies in child care centers were used as benchmarks. Reports of not fully implementing (nutrition-related policies or practices within rural early child care centers were identified. Centers not consistently serving a variety of fruits (48%), vegetables (45%), whole grains (41%), limiting saturated fat intake (31%), implementing healthy celebration guidelines (41%), involving children in mealtime (62%), and referring families to nutrition assistance programs (24%) were identified. More than one third of centers also had limited structured PA opportunities. Although eligible, only 48% of the centers participated in the Child and Adult Care Food Program. Overall, centers lacked parental outreach, staff training, and funding/resources to support nutrition and PA. These results provide insight into where child care centers within low-income, rural communities may need assistance to help prevent childhood obesity.

  17. Meeting the research infrastructure needs of micropolitan and rural communities.

    Science.gov (United States)

    Strasburger, Janette F

    2009-05-01

    In the 1800s, this country chose to establish land-grant colleges to see that the working class could attain higher education, and that the research needs of the agricultural and manufacturing segments of this country could be met. It seems contrary to our origins to see so little support at present for research infrastructure going to the very communities that need such research to sustain their populations, grow their economies, to attract physicians, to provide adequate health care, and to educate, retain, and employ their youth. Cities are viewed as sources for high-paying jobs, yet many of these same jobs could be translated to rural and micropolitan areas, provided that the resources are established to support it. One of the fastest growing economic periods in this country's history was during World War II, when even the smallest and most remote towns contributed substantially to the innovations, manufacture, and production of goods benefiting our nation as a whole. Rural areas have always lagged somewhat behind metropolitan areas in acquisition of new technology. Rural electricity and rural phone access are examples from the past. Testing our universities' abilities to grow distributive research networks beyond their campuses will create a competitive edge regionally, against global workplace, educational, and research competition, and will lay the groundwork for efficiency in research and for new innovation.

  18. Basidiomycete fungal communities in Australian sclerophyll forest soil are altered by repeated prescribed burning.

    Science.gov (United States)

    Anderson, Ian C; Bastias, Brigitte A; Genney, David R; Parkin, Pamela I; Cairney, John W G

    2007-04-01

    Soil basidiomycetes play key roles in forest nutrient and carbon cycling processes, yet the diversity and structure of below ground basidiomycete communities remain poorly understood. Prescribed burning is a commonly used forest management practice and there is evidence that single fire events can have an impact on soil fungal communities but little is known about the effects of repeated prescribed burning. We have used internal transcribed spacer (ITS) terminal restriction fragment length polymorphism (T-RFLP) analysis to investigate the impacts of repeated prescribed burning every two or four years over a period of 30 years on soil basidiomycete communities in an Australian wet sclerophyll forest. Detrended correspondence analysis of ITS T-RFLP profiles separated basidiomycete communities in unburned control plots from those in burned plots, with those burned every two years being the most different from controls. Burning had no effect on basidiomycete species richness, thus these differences appear to be due to changes in community structure. Basidiomycete communities in the unburned control plots were vertically stratified in the upper 20 cm of soil, but no evidence was found for stratification in the burned plots, suggesting that repeated prescribed burning results in more uniform basidiomycete communities. Overall, the results demonstrate that repeated prescribed burning alters soil basidiomycete communities, with the effect being greater with more frequent burning.

  19. Living in a continuous traumatic reality: Impact on elderly persons residing in urban and rural communities.

    Science.gov (United States)

    Regev, Irit; Nuttman-Shwartz, Orit

    2016-01-01

    This study is an exploration of the contribution of exposure to the continuous threat of Qassam rocket attacks to PTSD among elderly residents of urban and rural communities. Specifically, we examined the contribution of sociodemographic variables, psychological resources, and perceived social support to PTSD, and whether this relationship is mediated by cognitive appraisals. The sample consisted of 298 residents of 2 different communities: urban (n = 190), and rural (n = 108). We examined the main research question by calculating the correlations of the sociodemographic variables, the psychological resource (self-esteem), social support, and cognitive appraisals with the dependent variable (PTSD). Our model explained the variance in PTSD (53% for urban residents, and 56% for rural residents). Higher levels of PTSD were found among the urban residents. Most of the predictors contributed to PTSD, but differences were found between each type of community with regard to the combination of components. Results indicated that the type of community is related degree of protection against stress-related triggers such as Qassam rockets. The psychological resource (self-esteem) and cognitive appraisal variables were found to be important for older people facing a continuous threat, and can serve as a basis for professional intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Examining health and well-being outcomes associated with mining activity in rural communities of high-income countries: A systematic review.

    Science.gov (United States)

    Mactaggart, Fiona; McDermott, Liane; Tynan, Anna; Gericke, Christian

    2016-08-01

    It is recognised internationally that rural communities often experience greater barriers to accessing services and have poorer health outcomes compared to urban communities. In some settings, health disparities may be further exacerbated by mining activity, which can affect the social, physical and economic environment in which rural communities reside. Direct environmental health impacts are often associated with mining activity and are frequently investigated. However, there is evidence of broader, indirect health and well-being implications emerging in the literature. This systematic review examines these health and well-being outcomes in communities living in proximity to mining in high-income countries, and, in doing so, discusses their possible determinants. Four databases were systematically searched. Articles were selected if adult residents in mining communities were studied and outcomes were related to health or individual or community-level well-being. A narrative synthesis was conducted. Sixteen publications were included. Evidence of increased prevalence of chronic diseases and poor self-reported health status was reported in the mining communities. Relationship breakdown and poor family health, lack of social connectedness and decreased access to health services were also reported. Changes to the physical landscape; risky health behaviours; shift work of partners in the mine industry; social isolation and cyclical nature of 'boom and bust' activity contributed to poorer outcomes in the communities. This review highlights the broader health and well-being outcomes associated with mining activity that should be monitored and addressed in addition to environmental health impacts to support co-existence of mining activities and rural communities. © 2016 National Rural Health Alliance Inc.

  1. Building a sustainable workforce in a rural and remote health service: A comprehensive and innovative Rural Generalist training approach.

    Science.gov (United States)

    Orda, Ulrich; Orda, Sabine; Sen Gupta, Tarun; Knight, Sabina

    2017-04-01

    Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, CONCLUSIONS: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU. © 2016 National Rural Health Alliance Inc.

  2. Measuring teamwork and taskwork of community-based "teams" delivering life-saving health interventions in rural Zambia: a qualitative study.

    Science.gov (United States)

    Yeboah-Antwi, Kojo; Snetro-Plewman, Gail; Waltensperger, Karen Z; Hamer, Davidson H; Kambikambi, Chilobe; MacLeod, William; Filumba, Stephen; Sichamba, Bias; Marsh, David

    2013-06-27

    The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0-59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries.

  3. The association between economic development, lifestyle differentiation, and C-reactive protein concentration within rural communities in Hainan Island, China.

    Science.gov (United States)

    Inoue, Yosuke; Stickley, Andrew; Yazawa, Aki; Li, Dandan; Du, Jianwei; Jin, Yuming; Chen, Yan; Watanabe, Chiho

    2016-01-01

    Earlier fieldwork in rural areas of Hainan Island, China, demonstrated that during the course of economic development increasing differences had emerged in lifestyles within communities. It is possible that these variations might have stratified residents into subpopulations with different health attributes. This study examined the association between C-reactive protein (CRP) concentration, a biomarker of future cardiovascular events, and personal lifestyle parameters and the degree of community-level economic development among rural communities. A cross-sectional field survey was undertaken in 19 rural communities in Hainan. Convenience sampling was used to recruit 1,744 participants. Dried blood spot samples were collected to measure high-sensitivity CRP concentration. Sex-stratified multilevel regression analyses were conducted to identify factors associated with CRP concentration among the participants. While CRP concentration was negatively associated with being married and (more) education among men, for women CRP concentration was associated with the frequency of poultry consumption (P = 0.014) and the experience of migratory work in the previous year (P = 0.009). In addition, for females, living in communities with a greater degree of inequality, as indexed by the Gini coefficient, was also associated with increased CRP concentration (P = 0.003). Given that CRP concentration is a marker of future CVD risk, this study suggests that within these previously homogenous rural communities, economic development might have stratified people into population subgroups with a different CVD risk. © 2015 Wiley Periodicals, Inc.

  4. Thriving Together: Connecting Rural School Improvement and Community Development = Prosperando juntos: La conexion entre el mejoramiento de la escuela rural y el desarrollo comunitario.

    Science.gov (United States)

    Boethel, Martha

    Available in English or Spanish, this resource guide aims to help rural schools and communities learn ways of supporting each other so that both can thrive. Background information and basic tools are provided for starting a joint school-community development effort. Chapters contain: (1) outline of the guide and statement of beliefs about…

  5. Factors Related to Communication of Forest Fire Prevention Messages, a Study of Selected Rural Communities.

    Science.gov (United States)

    Griessman, B. Eugene; Bertrand, Alvin L.

    Two rural Louisiana communities were selected to evaluate the effectiveness of certain types of communication in preventing man-caused forest fires. The communities were selected on the basis of differences in fire occurrence rates and other factors related to conservation. Questionnaires and personal interviews were utilized to determine views of…

  6. Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing.

    Science.gov (United States)

    Clottey, Emmanuel N; Scott, Alison J; Alfonso, Moya L

    2015-01-01

    An increasing number of grandparents in rural USA are serving as primary caregivers for their grandchildren because of parental incarceration, addiction, joblessness, or illness. Low-income, African American women from the South are overrepresented in this growing population. There is a paucity of research exploring the challenges faced by rural grandparent caregivers, and past studies have not explicitly addressed the potential consequences of rural grandparent caregiving for health. The purpose of this qualitative study was to explore grandparent caregiving among rural, low-income, African American grandmothers in a community in the American South, and to identify challenges to health that arose in that context. McLeroy's social ecological model (SEM) was used to examine these challenges at multiple levels of influence. This qualitative interview-based study was conducted in a high-poverty community in rural Georgia. In-depth interviews were conducted with African American grandparent caregivers and key informants from local community-based organizations. A key informant assisted in identifying initial interview participants, and then snowball sampling was used to recruit additional participants. Interview questions were grouped under five domains (intrapersonal, interpersonal, community, organizational, and policy), according to the levels of the SEM. Iterative content analysis of interview transcripts was utilized. Transcripts were coded to identify text segments related to each domain of the SEM, which were grouped together for analysis by domain. Reflexive memo-writing aided in development of themes, and data quality was assessed using Lincoln and Guba's trustworthiness criteria. Rural African American grandparent caregivers faced a range of challenges to health. Direct physical challenges included chronic pain that interfered with sleep and daily functioning, mobility issues exacerbated by child care, and the pressure of managing their own medical conditions

  7. Epidemiology of Hymenolepis nana infections in primary school children in urban and rural communities in Zimbabwe.

    Science.gov (United States)

    Mason, P R; Patterson, B A

    1994-04-01

    Fecal specimens were obtained on 3 occasions at 10-12 wk intervals from 315 children in 3 rural villages in Zimbabwe and from 351 children in the high-density suburbs of an adjacent small town. Specimens were examined qualitatively and quantitatively for eggs of Hymenolepis nana, and these were found in 142 (21%) children. Infections occurred more frequently in younger children in the urban area but in older children in rural areas. The prevalence in urban areas (24%) was higher than in rural areas (18%), and in urban areas infection correlated with low "hygiene scores" (determined by observation) and with the presence in the household of an infected sibling. The prevalence of infection in the 3 rural communities did not correlate with availability of water, number of households per toilet, with low "hygiene scores," or with the presence of an infected sibling. Treatment with a single oral dose of 15 mg/kg praziquantel cured 84% of the infected children. New or reinfections occurred more frequently in households that had an infected sibling in an urban but not rural setting. The study demonstrates distinct differences in the transmission of H. nana infection in rural and urban communities. The data suggest intrafamily transmission in urban areas, particularly in households with poor hygiene behavior, leading to primary infection early in life. In rural areas, the prevalence of infection and the incidence of reinfection were highest in children of school age, and there was little evidence for intrafamily transmission of the parasite.

  8. The application of a biometric identification technique for linking community and hospital data in rural Ghana.

    Science.gov (United States)

    Odei-Lartey, Eliezer Ofori; Boateng, Dennis; Danso, Samuel; Kwarteng, Anthony; Abokyi, Livesy; Amenga-Etego, Seeba; Gyaase, Stephaney; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2016-01-01

    The reliability of counts for estimating population dynamics and disease burdens in communities depends on the availability of a common unique identifier for matching general population data with health facility data. Biometric data has been explored as a feasible common identifier between the health data and sociocultural data of resident members in rural communities within the Kintampo Health and Demographic Surveillance System located in the central part of Ghana. Our goal was to assess the feasibility of using fingerprint identification to link community data and hospital data in a rural African setting. A combination of biometrics and other personal identification techniques were used to identify individual's resident within a surveillance population seeking care in two district hospitals. Visits from resident individuals were successfully recorded and categorized by the success of the techniques applied during identification. The successes of visits that involved identification by fingerprint were further examined by age. A total of 27,662 hospital visits were linked to resident individuals. Over 85% of those visits were successfully identified using at least one identification method. Over 65% were successfully identified and linked using their fingerprints. Supervisory support from the hospital administration was critical in integrating this identification system into its routine activities. No concerns were expressed by community members about the fingerprint registration and identification processes. Fingerprint identification should be combined with other methods to be feasible in identifying community members in African rural settings. This can be enhanced in communities with some basic Demographic Surveillance System or census information.

  9. The application of a biometric identification technique for linking community and hospital data in rural Ghana

    Science.gov (United States)

    Odei-Lartey, Eliezer Ofori; Boateng, Dennis; Danso, Samuel; Kwarteng, Anthony; Abokyi, Livesy; Amenga-Etego, Seeba; Gyaase, Stephaney; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2016-01-01

    Background The reliability of counts for estimating population dynamics and disease burdens in communities depends on the availability of a common unique identifier for matching general population data with health facility data. Biometric data has been explored as a feasible common identifier between the health data and sociocultural data of resident members in rural communities within the Kintampo Health and Demographic Surveillance System located in the central part of Ghana. Objective Our goal was to assess the feasibility of using fingerprint identification to link community data and hospital data in a rural African setting. Design A combination of biometrics and other personal identification techniques were used to identify individual's resident within a surveillance population seeking care in two district hospitals. Visits from resident individuals were successfully recorded and categorized by the success of the techniques applied during identification. The successes of visits that involved identification by fingerprint were further examined by age. Results A total of 27,662 hospital visits were linked to resident individuals. Over 85% of those visits were successfully identified using at least one identification method. Over 65% were successfully identified and linked using their fingerprints. Supervisory support from the hospital administration was critical in integrating this identification system into its routine activities. No concerns were expressed by community members about the fingerprint registration and identification processes. Conclusions Fingerprint identification should be combined with other methods to be feasible in identifying community members in African rural settings. This can be enhanced in communities with some basic Demographic Surveillance System or census information. PMID:26993473

  10. The application of a biometric identification technique for linking community and hospital data in rural Ghana

    Directory of Open Access Journals (Sweden)

    Eliezer Ofori Odei-Lartey

    2016-03-01

    Full Text Available Background: The reliability of counts for estimating population dynamics and disease burdens in communities depends on the availability of a common unique identifier for matching general population data with health facility data. Biometric data has been explored as a feasible common identifier between the health data and sociocultural data of resident members in rural communities within the Kintampo Health and Demographic Surveillance System located in the central part of Ghana. Objective: Our goal was to assess the feasibility of using fingerprint identification to link community data and hospital data in a rural African setting. Design: A combination of biometrics and other personal identification techniques were used to identify individual's resident within a surveillance population seeking care in two district hospitals. Visits from resident individuals were successfully recorded and categorized by the success of the techniques applied during identification. The successes of visits that involved identification by fingerprint were further examined by age. Results: A total of 27,662 hospital visits were linked to resident individuals. Over 85% of those visits were successfully identified using at least one identification method. Over 65% were successfully identified and linked using their fingerprints. Supervisory support from the hospital administration was critical in integrating this identification system into its routine activities. No concerns were expressed by community members about the fingerprint registration and identification processes. Conclusions: Fingerprint identification should be combined with other methods to be feasible in identifying community members in African rural settings. This can be enhanced in communities with some basic Demographic Surveillance System or census information.

  11. Ecstasy use and depression: a 4-year longitudinal study among an Australian general community sample.

    Science.gov (United States)

    George, Amanda M; Olesen, Sarah; Tait, Robert J

    2013-10-01

    Longitudinal, population-based studies can better assess the relationship of ecstasy use with depression. We examined whether change in ecstasy use was associated with change in depressive symptoms/probable depression over a 4-year period, among a large Australian sample. The Personality and Total Health project is a longitudinal general community study of Australians from Canberra and Queanbeyan. Data from the youngest cohort when aged 24-30 (N = 2, 128) and 4 years later (N = 1, 977) was included. The Goldberg depression scale and the Brief Patient Health Questionnaire measured depressive symptoms and probable depression, respectively. Multilevel growth models also considered demographics, psychosocial characteristics, and other drug use. Ecstasy use was not associated with long-term depressive symptoms or greater odds of depression in multivariate analyses. Users had more self-reported depressive symptoms when using ecstasy compared to not using. However, differences between people who had and had not ever used ecstasy largely accounted for this. Other factors were more important in the prediction of depression. It would be premature to conclude that ecstasy use is not related to the development of long-term depressive symptoms, given the relatively low level of ecstasy and other drug use in this community sample. Results showed that other factors need to be considered when investigating ecstasy use and depression.

  12. Home is best: Why women in rural Zimbabwe deliver in the community.

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    Dodzo, Munyaradzi Kenneth; Mhloyi, Marvellous

    2017-01-01

    Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.

  13. Towards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.

    Directory of Open Access Journals (Sweden)

    Pamela Marie Pennington

    2017-09-01

    Full Text Available Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9% pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

  14. What Can Rural Communities Do to Be Sustained?

    Directory of Open Access Journals (Sweden)

    Rachel J. C. Chen

    2016-09-01

    Full Text Available Since the Appalachian Regional Commission (ARC was founded in 1965, various reports have been presented to summarize the progress in terms of economic development, strengths, weaknesses, opportunities, and threats among studied communities in the Appalachian region. The purposes of this study were to investigate (1 the condition and usage of facilities and services in the studied communities; (2 what factors contribute to local growth in improving areas; and (3 what barriers deter growth in the studied communities based on the perceptions of study participants. Ten studied counties were categorized based on their topography, demographics, and economics. Each sub-region has two selected counties (non-distressed and distressed to represent and compare their similar topography and various stages of demographic opportunities and economic development and challenges. Location is recognized as one of the significant factors that affect communities’ development. Counties perform better when they are adjacent to urban areas, own major transportation corridors, and have more supplies of natural resources than those located in more rural areas with fewer resources. This study noted the need to improve communication infrastructure (such as Internet access, broadband, and mobile communications that impact local development opportunities and public safety.

  15. Field Testing of a Small Water Purification System for Non-PRASA Rural Communities

    Science.gov (United States)

    Small, rural communities typically do not have adequate water purification systems to sustain their life quality and residents are exposed to pathogens present in drinking water. In Puerto Rico (PR), approximately 4% of the population does not have access to drinking water provi...

  16. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  17. The Family Life Project: an epidemiological and developmental study of young children living in poor rural communities.

    Science.gov (United States)

    Vernon-Feagans, Lynne; Cox, Martha

    2013-10-01

    About 20% of children in the United States have been reported to live in rural communities, with child poverty rates higher and geographic isolation from resources greater than in urban communities. There have been surprisingly few studies of children living in rural communities, especially poor rural communities. The Family Life Project helped fill this gap by using an epidemiological design to recruit and study a representative sample of every baby born to a mother who resided in one of six poor rural counties over a 1-year period, oversampling for poverty and African American. 1,292 children were followed from birth to 36 months of age. This monograph described these children and used a cumulative risk model to examine the relation between social risk and children's executive functioning, language development, and behavioral competence at 36 months. Using both the Family Process Model of development and the Family Investment Model of development, observed parenting was examined over time in relation to child functioning at 36 months. Different aspects of observed parenting were examined as mediators/moderators of risk in predicting child outcomes. Results suggested that cumulative risk was important in predicting all three major domains of child outcomes and that positive and negative parenting and maternal language complexity were mediators of these relations. Maternal positive parenting was found to be a buffer for the most risky families in predicting behavioral competence. In a final model using both family process and investment measures, there was evidence of mediation but with little evidence of the specificity of parenting for particular outcomes. Discussion focused on the importance of cumulative risk and parenting in understanding child competence in rural poverty and the implications for possible intervention strategies that might be effective in maximizing the early development of these children.

  18. Translation of tobacco policy into practice in disadvantaged and marginalized subpopulations: a study of challenges and opportunities in remote Australian Indigenous communities

    Directory of Open Access Journals (Sweden)

    Robertson Jan A

    2012-07-01

    Full Text Available Abstract Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT, extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive

  19. Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru.

    Science.gov (United States)

    Bartoloni, Alessandro; Pallecchi, Lucia; Fernandez, Connie; Mantella, Antonia; Riccobono, Eleonora; Magnelli, Donata; Mannini, Dario; Strohmeyer, Marianne; Bartalesi, Filippo; Segundo, Higinio; Monasterio, Joaquin; Rodriguez, Hugo; Cabezas, César; Gotuzzo, Eduardo; Rossolini, Gian Maria

    2013-05-01

    To investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in rural and urban community settings of Bolivia and Peru. MRSA nasal carriage was investigated in 585 individuals living in rural and urban areas of Bolivia and Peru (one urban area, one small rural village, and two native communities, one of which was highly isolated). MRSA isolates were subjected to molecular analysis for the detection of virulence genes, characterization of the staphylococcal cassette chromosome mec (SCCmec), and genotyping (multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)). An overall very low prevalence of MRSA nasal carriage was observed (0.5%), with MRSA carriers being detected only in a small rural village of the Bolivian Chaco. The three MRSA isolates showed the characteristics of community-associated MRSA (being susceptible to all non-beta-lactam antibiotics and harboring the SCCmec type IV), were clonally related, and belonged to ST1649. This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  20. Engaging the underserved: a process model to mobilize rural community health coalitions as partners in translational research.

    Science.gov (United States)

    Davis, Melinda M; Aromaa, Susan; McGinnis, Paul B; Ramsey, Katrina; Rollins, Nancy; Smith, Jamie; Beamer, Beth Ann; Buckley, David I; Stange, Kurt C; Fagnan, Lyle J

    2014-08-01

    Community engagement (CE) and community-engaged research (CEnR) are increasingly recognized as critical elements in research translation. Process models to develop CEnR partnerships in rural and underserved communities are needed. Academic partners transformed four established Community Health Improvement Partnerships (CHIPs) into Community Health Improvement and Research Partnerships (CHIRPs). The intervention consisted of three elements: an academic-community kickoff/orientation meeting, delivery of eight research training modules to CHIRP members, and local community-based participatory research (CBPR) pilot studies addressing childhood obesity. We conducted a mixed methods analysis of pre-/postsurveys, interviews, session evaluations, observational field notes, and attendance logs to evaluate intervention effectiveness and acceptability. Forty-nine community members participated; most (78.7%) attended five or more research training sessions. Session quality and usefulness was high. Community members reported significant increases in their confidence for participating in all phases of research (e.g., formulating research questions, selecting research methods, writing manuscripts). All CHIRP groups successfully conducted CBPR pilot studies. The CHIRP process builds on existing infrastructure in academic and community settings to foster CEnR. Brief research training and pilot studies around community-identified health needs can enhance individual and organizational capacity to address health disparities in rural and underserved communities. © 2014 Wiley Periodicals, Inc.

  1. Issues in rural adolescent mental health in Australia.

    Science.gov (United States)

    Boyd, Candice P; Aisbett, Damon L; Francis, Kristy; Kelly, Melinda; Newnham, Krystal; Newnham, Karyn

    2006-01-01

    The mental health of adolescents living in rural Australia has received little research attention. In this article, the extant literature on rural adolescent mental health in Australia is reviewed. Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article. The case represented by the vignette is that of a young Australian growing up in a rural area. The issues raised--including the nature of mental health issues for rural adolescents and barriers to seeking professional help--are then discussed in terms of the available literature. The article concludes with a future focus for research efforts in the area of rural adolescent mental health.

  2. Stigmatization of people with mental illness among inhabitants of a rural community in northern Nigeria.

    Science.gov (United States)

    Audu, Ishaq A; Idris, Suleiman H; Olisah, Victor O; Sheikh, Taiwo L

    2013-02-01

    Despite the fact that mental illness is a common problem in society, people's perception of the mentally ill and community attitude towards them is still rather poor, making their rehabilitation and reintegration into society an uphill task. To examine the stigmatization of people with mental illness within a rural community and identify the socio-demographic variables involved. A cross-sectional descriptive study using a multi-stage random sampling technique to obtain data through an interviewer-administered questionnaire to 325 adult inhabitants of a rural community in Nigeria. The results showed widespread ignorance about causation, mode of transmission and remedies available for mental illness, with only 0.9% of respondents attributing mental illness to brain disease. The others attributed it to spiritual attack, punishment for evil doing and illicit psychoactive substance use, among other things. Negative views about the mentally ill were also widely expressed resulting in discriminatory practices. Stigmatization of people with mental illness is still rampant in our community. There is a need for adequate public education about the causes and mode of transmission of mental illness and the treatment options available in the community.

  3. Physical Activity–Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002–2013

    Science.gov (United States)

    Perry, Cynthia K.; Sumrall, Jasmin C.; Patterson, Megan S.; Walsh, Shana M.; Clendennen, Stephanie C.; Hooker, Steven P.; Evenson, Kelly R.; Goins, Karin V.; Heinrich, Katie M.; O’Hara Tompkins, Nancy; Eyler, Amy A.; Jones, Sydney; Tabak, Rachel; Valko, Cheryl

    2016-01-01

    Introduction Health disparities exist between rural and urban residents; in particular, rural residents have higher rates of chronic diseases and obesity. Evidence supports the effectiveness of policy and environmental strategies to prevent obesity and promote health equity. In 2009, the Centers for Disease Control and Prevention recommended 24 policy and environmental strategies for use by local communities: the Common Community Measures for Obesity Prevention (COCOMO); 12 strategies focus on physical activity. This review was conducted to synthesize evidence on the implementation, relevance, and effectiveness of physical activity–related policy and environmental strategies for obesity prevention in rural communities. Methods A literature search was conducted in PubMed, PsycINFO, Web of Science, CINHAL, and PAIS databases for articles published from 2002 through May 2013 that reported findings from physical activity–related policy or environmental interventions conducted in the United States or Canada. Each article was extracted independently by 2 researchers. Results Of 2,002 articles, 30 articles representing 26 distinct studies met inclusion criteria. Schools were the most common setting (n = 18 studies). COCOMO strategies were applied in rural communities in 22 studies; the 2 most common COCOMO strategies were “enhance infrastructure supporting walking” (n = 11) and “increase opportunities for extracurricular physical activity” (n = 9). Most studies (n = 21) applied at least one of 8 non-COCOMO strategies; the most common was increasing physical activity opportunities at school outside of physical education (n = 8). Only 14 studies measured or reported physical activity outcomes (10 studies solely used self-report); 10 reported positive changes. Conclusion Seven of the 12 COCOMO physical activity–related strategies were successfully implemented in 2 or more studies, suggesting that these 7 strategies are relevant in rural communities and the

  4. The symbolic representation of community in social isolation and loneliness among older people: Insights for intervention from a rural Irish case study.

    Science.gov (United States)

    Bantry-White, Eleanor; O'Sullivan, Siobhán; Kenny, Lorna; O'Connell, Cathal

    2018-07-01

    Social isolation and loneliness are common experiences of ageing in rural communities. Policy responses and interventions for social isolation and loneliness in later life are shaped by sociocultural understandings of place, relationships and social interaction. This study examined how representations of rural community in Ireland influenced the focus, relationships and activities within a befriending intervention designed to tackle social isolation and loneliness. Through a qualitative case study conducted in 2014, the symbolic meaning of the intervention was explored using interviews and focus groups with participants (8 befriended, 11 befrienders and 3 community workers) from one befriending programme in rural Ireland. Reflected in the programme was a representation of a rural community in decline with concern for the impact on older people. There was a valuing of the traditional community defined by geographical place, perceptions of similarity among its members, and values of solidarity and mutual support. The befriending intervention represented a commitment to intra-community solidarity and a desire by many for authentic befriending relationships that mirrored understandings of relationships within the traditional community. Identifying and alleviating social isolation and loneliness imply a set of normative values about community and the optimal social relationships within community. This paper proposes that there is a need to consider the role played by understandings of community in shaping context-sensitive interventions to counter social isolation and loneliness in later life. © 2018 John Wiley & Sons Ltd.

  5. Gut bacterial community structure of two Australian tropical fruit fly species (Diptera: Tephritidae

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    Narit Thaochan

    2015-12-01

    Full Text Available The community structure of the alimentary tract bacteria of two Australian fruit fly species, Bactrocera cacuminata (Hering and Bactrocera tryoni (Froggatt, was studied using a molecular cloning method based on the 16S rRNA gene. Differences in the bacterial community structure were shown between the crops and midguts of the two species and sexes of each species. Proteobacteria was the dominant bacterial phylum in the flies, especially bacteria in the order Gammaproteobacteria which was prominent in all clones. The total bacterial community consisted of Proteobacteria (more than 75% of clones, except in the crop of B. cacuminata where more than 50% of clones belonged to Firmicutes. Firmicutes gave the number of the secondary community structure in the fly’s gut. Four orders, Alpha-, Beta-, Delta- and Gammaproteobacteria and the phyla Firmicutes and Actinobacteria were found in both fruit fly species, while the order Epsilonproteobacteria and the phylum Bacteroidetes were found only in B. tryoni. Two phyla, Actinobacteria and Bacteroidetes, were rare and less frequent in the flies. There was a greater diversity of bacteria in the crop of the two fruit fly species than in the midgut. The midgut of B. tryoni females and the midgut of B. cacuminata males had the lowest bacterial diversity.

  6. He Could Be Undocumented: Striving to Be Sensitive to Student Documentation Status in a Rural Community

    Science.gov (United States)

    Crawford, Emily R.; Hairston, Sarah L.

    2018-01-01

    This case study takes place in a Midwestern, politically conservative rural community shortly after a highly contested presidential election. Like other communities, Paisano has experienced demographic change in a relatively short time. Meat processing plants and construction jobs proliferate, attracting migrant workers. One day, secondary school…

  7. Case Study of Leadership Practices and School-Community Interrelationships in High-Performing, High-Poverty, Rural California High Schools

    Science.gov (United States)

    Masumoto, Marcia; Brown-Welty, Sharon

    2009-01-01

    Many rural California high schools are impacted by the disadvantages of poverty, non-English speaking students, limited resources, changing demographics, and challenges of the rural context. Focusing on contemporary leadership theories and school-community interrelationships, this qualitative study examines the practices of educational leaders in…

  8. Community adaptations to an impending food desert in rural Appalachia, USA.

    Science.gov (United States)

    Miller, Wayne C; Rogalla, Denver; Spencer, Dustin; Zia, Nida; Griffith, Brian N; Heinsberg, Haylee B

    2016-01-01

    The United States Department of Agriculture (USDA) describes a food desert as an urban neighborhood or rural town without ready access to fresh, healthy, and affordable food. An estimated 2.3 million rural Americans live in food deserts. One goal of the USDA is to eliminate food deserts. However, at a time when some food deserts are being eliminated, hundreds of grocery stores are closing, causing other food deserts to arise. The literature is scarce on how a community adapts to an impending food desert. Alderson, West Virginia, USA (population 1184) rallied to face an impending food desert when the only grocery store in town closed in December 2014. This study investigated how this small rural community adapted to its oncoming food desert. A community member survey was administered to 155 Alderson families (49%) to determine how the new food desert affected family food acquisition and storage behaviors. A restaurant survey was given to the town's four restaurants to determine how the food desert affected their businesses. Sales data for a new food hub (Green Grocer) was obtained to see if this new initiative offset the negative effects of the food desert. ANOVA and t-tests were used to compare group numerical data. Two group response rates were compared by testing the equality of two proportions. Categorical data were analyzed with the χ2 or frequency distribution analysis. Group averages are reported as mean ± standard error of the mean. Significance for all analyses was set at pp=0.16) from the number before the food desert (2.8±0.3). Price comparisons among the Green Grocer and three distant supermarkets showed a 30% savings by traveling to distant supermarkets. Frequency of monthly restaurant visits did not change after the emergence of the food desert (2.98±0.54 vs 3.05±0.51, p=0.85). However, restaurant patrons requested to buy fresh produce and dairy from the restaurants to use for their own home cooking. Food pantry use increased by 43%, with

  9. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    Science.gov (United States)

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  10. A tale of two communities: intestinal polyparasitism among Orang Asli and Malay communities in rural Terengganu, Malaysia.

    Science.gov (United States)

    Elyana, Fatin Nur; Al-Mekhlafi, Hesham M; Ithoi, Init; Abdulsalam, Awatif M; Dawaki, Salwa; Nasr, Nabil A; Atroosh, Wahib M; Abd-Basher, Mohamad Hafiz; Al-Areeqi, Mona A; Sady, Hany; Subramaniam, Lahvanya R; Anuar, Tengku Shahrul; Lau, Yee Ling; Moktar, Norhayati; Surin, Johari

    2016-07-16

    Intestinal parasitic infections (IPIs) are still major health problems in many developing countries including Malaysia, particularly in the poor and socioeconomically deprived rural and remote communities in Peninsular Malaysia. This study was conducted to determine the prevalence of IPIs and to identify the key factors associated with intestinal polyparasitism as well as to evaluate the knowledge, attitude and practices (KAP) on IPIs among rural Orang Asli and Malay communities in Terengganu, Malaysia. A cross-sectional study was conducted among 340 participants (165 Orang Asli and 175 Malay) aged ≤ 15 years from the Hulu Terengganu and Kemaman districts of Terengganu. Faecal samples were examined for the presence of intestinal parasites by using direct smear, formalin-ether sedimentation, trichrome stain, modified Ziehl Neelsen stain, in vitro cultivation in Jones' medium, Kato Katz and Harada Mori techniques. Demographic, socioeconomic, environmental and behavioural information of the participants and their KAP for IPIs were collected by using a pre-tested questionnaire. Overall, 149 (90.3 %) Orang Asli and 43 (24.6 %) Malay children were infected by at least one parasite species. The overall prevalences of intestinal polyparasitism among the Orang Asli and Malay were 68.5 % (113/165) and 14.3 % (25/175), respectively. Multiple logistic regression analysis showed that using unsafe water supply as a source for drinking water, the presence of domestic animals, not wearing shoes when outside, not washing vegetables before consumption, not washing hands after playing with soil, indiscriminate defecation and the low level of mother's education were the key risk factors for intestinal polyparasitism among the Orang Asli, while working mothers and the presence of domestic animals were the risk factors among the Malay children. Almost all the Malays were well aware about the IPIs while Orang Asli respondents had a poor level of related awareness. This study

  11. Electricity access for geographically disadvantaged rural communities - technology and policy insights

    Energy Technology Data Exchange (ETDEWEB)

    Chaurey, A.; Malini Ranganathan [The Energy and Resources Institute, New Delhi (India). India Habitat Centre; Parimita Mohanty [Jadavpur University, Kolkota (India). School of Energy Studies

    2004-10-01

    The purpose of this paper is to weigh the issues and options for increasing electricity access in remote and geographically challenged villages in interior Rajasthan, the desert state in Western India where power sector reforms are currently underway. By first providing an overview of reforms and various electrification policy initiatives in India, the paper then analyzes the specific problems as studied at the grass-roots level with respect to rural electricity access and the use of off-grid renewables. Finally, it discusses interventions that could facilitate access to electricity by suggesting a sequential distributed generation (DG)-based approach, wherein consecutive DG schemes-incorporating the requisite technological, financial, and institutional arrangements-are designed depending on the developmental requirements of the community. In essence, this approach fits under the broader need to understand how the three ''Rs'' - rural electrification (the process), power sector reforms (the catalyst), and the use of renewable energy technologies (the means)- could potentially converge to meet the needs of India's rural poor. (author)

  12. Marketing of rural and remote pharmacy practice via the digital medium.

    Science.gov (United States)

    Peterson, G M; Fitzmaurice, K D; Rasiah, R L; Kruup, H

    2010-08-01

    The shortage of community and hospital pharmacists is particularly acute in rural and remote areas of Australia. Pharmacy students, in particular, as those who may be able to alleviate this shortage, need to be made more aware of the challenges and rewards of rural pharmacy practice. A marketing tool was developed to promote rural and remote pharmacy practice as a career option. A DVD was produced from interviews with health professionals working in rural and remote areas of Australia. This DVD will complement current rural practical placements, which have been incorporated into the curriculum of Australian schools of pharmacy. Interviews were conducted with healthcare professionals from areas in Tasmania, Northern Queensland and the Northern Territory. Interviewees included pharmacists, graduate pharmacists, pharmacy students, aboriginal health workers and a general practitioner. Each of the interviewees was able to provide personal accounts of experiences in rural and remote healthcare, and roles and opportunities for pharmacists. A final draft of the DVD was shown to University of Tasmania students to assess the impact and quality of the production. A number of common themes arose from interviewing and these were subsequently converted into five key chapters of the DVD - Lifestyle, Belonging, Diversity, Indigenous Health and 'Give it a go'. The final DVD, produced from over 15 h of footage, runs for 35 min. Students reported positive feedback on both the technical quality and the information contained within the DVD; 37% of students who viewed the DVD felt that it increased their awareness of what rural pharmacy has to offer. The rural pharmacy, 'Enjoy the Lifestyle' DVD can be used to increase awareness of rural and remote pharmacy practice to students and other pharmacists, and complements other pharmacy workforce strategies for rural and remote areas of Australia. It could also be a useful approach for adaptation in other countries.

  13. Who attracts whom to rural general practice? Variation in temperament and character profiles of GP registrars across different vocational training pathways.

    Science.gov (United States)

    Eley, Diann S; Laurence, Caroline; Cloninger, C R; Walters, Lucie

    2015-01-01

    The ongoing rural doctor workforce shortage continues to stimulate interest in new strategies to alleviate the situation. Alongside increasingly promising approaches is the notion that attracting and nurturing the 'right' individuals may be paramount to achieving long-term success in recruitment and retention. This study compares the patterns of demographic and temperament and character trait profiles of general practice registrars in training across three Australian vocational training pathways: the Australian College of Rural and Remote Medicine independent rural pathway, and the rural and general pathways of Australian general practice training. The aim is to describe the predominant personalities of existing trainees. At its foundation, this study strives to obtain more information about those individuals choosing rural practice, which may inform ways to enhance future recruitment and training into rural medicine. This rationale has been explored with medical students using intention as the dependent variable, but registrars are that much closer to their final career choice, and therefore may provide more practical and reliable indicators of the notion of who attracts whom into rural practice. A cross-sectional design sampled four registrar training groups: one from the Australian College of Rural and Remote Medicine, one Australian general practice training rural only, and two Australian general practice training rural and general pathway regional training providers. Registrars (451) completed a questionnaire that gathered basic demographics and a personality trait profile using the Temperament and Character Inventory plus a measure of resilience. Statistical analysis explored the relationships between variables (multivariate analyses of variance) and compared levels of traits between registrar groups (analyses of variance). Registrars training via the Australian College of Rural and Remote Medicine pathway were more likely to be male, older, have a definite

  14. Community Participation and Barriers in Rural Tourism: A Case Study in Kiulu, Sabah

    OpenAIRE

    Velnisa Paimin N. F.; Modilih S.; Mogindol S. H.; Johnny C.; Thamburaj J. A.

    2014-01-01

    The paper presents an investigation on local community participation and barriers in rural tourism. It identifies two sides of community participation in tourism as identified by Timothy [5], which are; the benefits point of view and from the decision making process perspective. It also identifies the communities’ barriers in engaging in tourism and uses Tosun’s [18] approach in examining the barriers. A total of eighty-three questionnaire forms were completed by respondents from seven villag...

  15. Depression, Anxiety and Somatic Complaints in Colombian Children Living in Rural Communities

    Directory of Open Access Journals (Sweden)

    Ruby C. Castilla Puentes

    2013-08-01

    Full Text Available Introduction: In Colombia, children are frequently exposed to traumatic events; however, there are no data regarding the impact on depression, anxiety and somatic correlates of such exposure in children living in rural communities. Objective: To investigate the somatic complaints and symptoms of depression and anxiety among children exposed to traumatic events in a rural community of Colombia. Methods: Design: Cross-Sectional study. Participants: Two hundred and ninety-three Colombian children aged eight to 18 years. Main Outcome Measures: Standardized measures were administered to assess children's depression, anxiety, physical symptoms and exposure to traumatic events. Depression: CDI (Children's Depression Inventory; anxiety: SCARED (The Screen for Child Anxiety Related Emotional Disorders; somatic complaints: CBCL (Child Behavior Checklist, Somatic Complaints scale and reporting traumatic events during the K-SADS-PL (Diagnostic Interview for Children and Adolescents. Results: Ninety-one of the 293 children (31.1% reported somatic complaints. The most common somatic complaint was in the gastrointestinal category (35/91. One hundred and seventy eight children (60.5% had observed traumatic events, including homicides during the last month. Two hundred five (69.9% of the children showed depressive symptom profiles above established norms, and 239 (81.6% exhibited anxiety symptoms according to their own reports. The correlation between depression and traumatic events, anxiety and somatic complaints, and between anxiety and depression were statistically significant (p<0.005. Conclusions: As the first study of its kind in children living in rural communities in Colombia, it demonstrates a clear impact of traumatic events on mental health. Information that somatic complaints are commonly an expression of underlying depression and anxiety may facilitate the treatment and thereby help avoid unnecessary medical workups and sequelae from traumatized

  16. Enhancing User Access to Australian marine data - the Australian Ocean Data Network

    Science.gov (United States)

    Proctor, R.; Mancini, S.; Blain, P. J.

    2017-12-01

    The Integrated Marine Observing System (IMOS) is a national project funded by the Australian government established to deliver ocean observations to the marine and climate science community. Now in its 10th year its mission is to undertake systematic and sustained observations and to turn them into data, products and analyses that can be freely used and reused for broad societal benefits. As IMOS has matured as an observing system the expectation of the system's availability and reliability has also increased and IMOS is now seen as delivering `operational' information; it does this through the Australian Ocean Data Network (AODN). The AODN runs its services in the commercial cloud service Amazon Web Services. This has enabled the AODN to improve the system architecture, utilizing more advanced features like object storage (S3 - Simple Storage Service) and autoscaling features, and introducing new checking and logging procedures in a pipeline approach. This has improved data availability and resilience while protecting against human errors in data handling and providing a more efficient ingestion process. Many of these features are available through AODN to the wider Australian marine and science community enabling the `family' of AODN to grow, thereby enabling rapid access to an increasing collection of ocean observations.

  17. Partnering with Communities to Address the Mental Health Needs of Rural Veterans

    Science.gov (United States)

    Kirchner, JoAnn E.; Farmer, Mary Sue; Shue, Valorie M.; Blevins, Dean; Sullivan, Greer

    2011-01-01

    Purpose: Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF). Methods:…

  18. Exploring Culturally Specific Drug Resistance Strategies of Hawaiian Youth in Rural Communities

    Science.gov (United States)

    Okamoto, Scott K.; Po'a-Kekuawela, Ka'ohinani; Chin, Coralee I. H.; Nebre, La Risa H.; Helm, Susana

    2010-01-01

    This qualitative study examined the drug resistance strategies of Hawaiian youth residing in rural communities in Hawai'i. Forty seven youth participated in 14 focus groups which focused on the social and environmental context of drug use for these youth. The findings indicated that there were 47 references to resistance strategies used in drug…

  19. Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

    NARCIS (Netherlands)

    Havenaar, Juhan; Geerlings, Mirjan; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

    2007-01-01

    This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were

  20. The Tie That Binds: Leadership and Liberal Arts Institutions' Civic Engagement Commitment in Rural Communities

    Science.gov (United States)

    Goodman, Hunter Phillips

    2014-01-01

    Community boundary spanners create ties that bind the campus and its surrounding region for reciprocal relationships. Using community boundary spanning literature as a conceptual framework, this study went beyond existing research on public and 4-year comprehensive universities to examine how university leadership at rural, private liberal arts…

  1. Medical-attention injuries in community Australian football: a review of 30 years of surveillance data from treatment sources.

    Science.gov (United States)

    Ekegren, Christina L; Gabbe, Belinda J; Finch, Caroline F

    2015-03-01

    In recent reports, Australian football has outranked other team sports in the frequency of hospitalizations and emergency department (ED) presentations. Understanding the profile of these and other "medical-attention" injuries is vital for developing preventive strategies that can reduce health costs. The objective of this review was to describe the frequency and profile of Australian football injuries presenting for medical attention. A systematic search was carried out to identify peer-reviewed articles and reports presenting original data about Australian football injuries from treatment sources (hospitals, EDs, and health-care clinics). Data extracted included injury frequency and rate, body region, and nature and mechanism of injury. Following literature search and review, 12 publications were included. In most studies, Australian football contributed the greatest number of injuries out of any sport or recreation activity. Hospitals and EDs reported a higher proportion of upper limb than lower limb injuries, whereas the opposite was true for sports medicine clinics. In hospitals, fractures and dislocations were most prevalent out of all injuries. In EDs and clinics, sprains/strains were most common in adults and superficial injuries were predominant in children. Most injuries resulted from contact with other players or falling. The upper limb was the most commonly injured body region for Australian football presentations to hospitals and EDs. Strategies to prevent upper limb injuries could reduce associated public health costs. However, to understand the full extent of the injury problem in football, treatment source surveillance systems should be supplemented with other datasets, including community club-based collections.

  2. Australian Seismometers in Schools: Apps, Archiving and Adventures

    Science.gov (United States)

    Balfour, N.; Salmon, M.; Sambridge, M.

    2014-12-01

    Global earthquake activity provides an opportunity to actively engage students and teachers in the Earth Sciences. With earthquakes often hitting the news headlines the Australian Seismometers in Schools (AuSIS) program utilizes the resulting public awareness and curiosity, providing tools and support for teachers and students to find out more. Most teachers are unaware of the wealth of resources available and often lack confidence to teach earth science, as they have little to no formal training. With the introduction of earth science to the national curriculum it has become imperative teachers receive this support. AuSIS connects students and teachers with earthquake data relevant to them that is both real-time and easily accessible. The biggest challenge faced is often how to engage with remote and rural communities over the vast Australian continent. Our approach has been to take information to the teachers, providing workshops at national science teacher conferences and developing guides that provide step-by-step instructions for classroom activities. These professional development workshops include hands-on demonstrations as well as online discovery. The data recorded at schools on our network of seismometers is publicly accessible and is shared with scientists, amateur seismologists and students alike, this provides students with a sense of involvement in the scientific community. We link teachers with additional online resources and utilize social media to alert them to interesting earth science facts and earthquake activity. For continued exploration we provide easy access to our data and earthquake information through a mobile app and website. Our website combines both local and global earthquake catalogs to provide a one-stop shop of earthquake information of interest to the teachers and students. We also encourage online interactions with teachers through a forum on our website and through social media aimed to provide continued support.

  3. Personality characteristics and attributes of international medical graduates in general practice training: Implications for supporting this valued Australian workforce.

    Science.gov (United States)

    Laurence, Caroline O; Eley, Diann S; Walters, Lucie; Elliott, Taryn; Cloninger, Claude Robert

    2016-10-01

    To describe the personality profiles of International Medical Graduates (IMGs) undertaking General Practice (GP) training in Australia. A better understanding of the personal characteristics of IMGs may inform their training and enhance support for their vital contribution to the Australian rural workforce. Cross-sectional self-report questionnaires. Independent variables included socio-demographics, prior training, the Temperament and Character Inventory, and the Resilience Scale. GP registrars (IMGs = 102; AMGs = 350) training in the Australian General Practice Training rural and general pathway and the Australian College of Rural and Remote Medicine independent pathway. Univariate analysis explored the differences in levels of traits between IMG and AMG registrars. Compared to the general population both groups have moderately high resilience, and well-organised characters with high Self-directedness, high Cooperativeness and low Self-transcendence, supported by temperaments which were high in Persistence and Reward Dependence. IMGs were different than AMGs in two temperament traits, Novelty Seeking and Persistence and two character traits, Self-directedness and Cooperativeness. Factors such as cultural and training backgrounds, personal and professional expectations, and adjustments necessary to assimilate to a new lifestyle and health system are likely to be responsible for differences found between groups. Understanding the personality profiles of IMGs provides opportunities for targeted training and support which may in turn impact on their retention in rural areas. © 2016 National Rural Health Alliance Inc.

  4. Assets and Affect in the Study of Social Capital in Rural Communities

    Science.gov (United States)

    Phillips, Martin

    2015-01-01

    Abstract Shucksmith (2012) has recently suggested that rural research might be refreshed by incorporating theoretical insights that have emerged through a renewal of class analysis. This article seeks to advance this proposed research agenda by exploring the concept of asset‐based class analysis and its association with the concept of social capital. The article explores connections between social capital, class analysis and understandings of community, noting how all have been associated with long running and unresolved debates. Attention is drawn to the problems of modernist legislative approaches to these debates and the value of adopting more interpretive perspectives. A distinction between ‘infrastructural’ and ‘culturalist’ interpretations of social capital is explored in relation to ‘asset‐based’ theorisations of class and culture. It is argued that an infrastructural conception of social capital might usefully be employed in association with a disaggregated conception of cultural capital that includes consideration of emotion and affect, as well as institutional, objectified and technical assets. These arguments are explored using studies of rural communities, largely within Britain. PMID:27563158

  5. Young adults’ perceptions of and affective bonds to a rural tourism community

    Directory of Open Access Journals (Sweden)

    Peter Möller

    2016-02-01

    Full Text Available Many rural areas, in Sweden and worldwide, experience population decline where the young leave for education and work in urban areas. Employment has declined in several rural industries, such as agriculture, forestry, and fishing, while growing in other industries are often located in urban areas. Politicians and organizations have put much hope in tourism as a tool of rural development, but can tourism help reverse the rural out-migration trend among young adults? This paper explores how tourism affects young inhabitants’ perceptions of and affective bonds to a rural area in Sweden, the ski resort of Sälen. Students from the 1993–1995 elementary school graduating classes were interviewed about their migration history, childhood, and view of and ties to Sälen. The respondents experience that tourism contributes to a more vital community incorporating influences from elsewhere, but without eliminating the positive aspects of rural life. The regular flow of people – tourists, seasonal workers, and entrepreneurs – passing through Sälen presents opportunities to extend one’s social network that are widely appreciated by respondents. The high in and out mobility constitutes a key part of Sälen’s character. Contributions from tourism – such as employment, entertainment, leisure, and opportunities to forge new social relationships – are available during the adult transition, the life phase when rural areas are often perceived as least attractive. Even though out-migration occurs in Sälen, and some respondents still find Sälen too small, tourism has clearly increased the available opportunities and contributed significantly to making Sälen more attractive to young adults.

  6. Vectors and malaria transmission in deforested, rural communities in north-central Vietnam

    Directory of Open Access Journals (Sweden)

    Do Manh Cuong

    2010-09-01

    Full Text Available Abstract Background Malaria is still prevalent in rural communities of central Vietnam even though, due to deforestation, the primary vector Anopheles dirus is uncommon. In these situations little is known about the secondary vectors which are responsible for maintaining transmission. Basic information on the identification of the species in these rural communities is required so that transmission parameters, such as ecology, behaviour and vectorial status can be assigned to the appropriate species. Methods In two rural villages - Khe Ngang and Hang Chuon - in Truong Xuan Commune, Quang Binh Province, north central Vietnam, a series of longitudinal entomological surveys were conducted during the wet and dry seasons from 2003 - 2007. In these surveys anopheline mosquitoes were collected in human landing catches, paired human and animal bait collections, and from larval surveys. Specimens belonging to species complexes were identified by PCR and sequence analysis, incrimination of vectors was by detection of circumsporozoite protein using an enzyme-linked immunosorbent assay. Results Over 80% of the anopheline fauna was made up of Anopheles sinensis, Anopheles aconitus, Anopheles harrisoni, Anopheles maculatus, Anopheles sawadwongporni, and Anopheles philippinensis. PCR and sequence analysis resolved identification issues in the Funestus Group, Maculatus Group, Hyrcanus Group and Dirus Complex. Most species were zoophilic and while all species could be collected biting humans significantly higher densities were attracted to cattle and buffalo. Anopheles dirus was the most anthropophilic species but was uncommon making up only 1.24% of all anophelines collected. Anopheles sinensis, An. aconitus, An. harrisoni, An. maculatus, An. sawadwongporni, Anopheles peditaeniatus and An. philippinensis were all found positive for circumsporozoite protein. Heterogeneity in oviposition site preference between species enabled vector densities to be high in both

  7. The levels of Community Involvement in Health (CIH: a case of rural and urban communities in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    G.G. Mchunu

    2009-09-01

    Full Text Available The study aimed to describe the practice of community involvement in health programmes.The study therefore explored the nature and practice of community involvementin health programmes in the two communities in KwaZulu Natal. Thestudy was guided by the conceptual framework adapted from Amstein’s,( 1969 Ladderof Citizen Participation. This framework shows different levels and steps in communityparticipation. A case study method was used to conduct the study. The twocases were one urban based and one rural based community health centers in theIlembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in thestudy. The sample comprised 8 registered nurses, 2 enrolled nurses 13 communitymembers and 8 community health workers. Data was collected using structured individualinterviews and focus group interviews, and was guided by the case protocol.Community involvement in health largely depended on the type of community, withrural community members being in charge of their health projects and urban communitymembers helping each other as neighbours in times of need.

  8. Attitude and Entrepreneurial Intention Among Rural Community: the Mediating Role of Entrepreneurial Opportunity Recognition

    Directory of Open Access Journals (Sweden)

    Dahalan Norziani

    2015-01-01

    Full Text Available Entrepreneurship has been well documented to have an economic and social implication for the nation to increase income. Most of developing countries give further consideration to include entrepreneurship as an agenda to help the poor to increase the living standard. In fact, entrepreneurship offers various business opportunities for rural communities to achieve better quality of life. However, the crucial part of doing business is to recognize business opportunity. Entrepreneurship and opportunity are two terms that complement each other. Opportunity recognition enables the entrepreneur to identify a good idea and transform it into a business concept. The purpose of this study is to examine the relationship between attitude (attitude toward money, attitude toward start-up and entrepreneurial intention. This paper also intends to understand the role of entrepreneurial opportunity recognition as a mediator between attitude and entrepreneurial intention. The aim of this research is to support training providers, to identify input for entrepreneurial training, specifically developing business concepts among rural community. From the practical perspective, it might help the government to understand the necessity to encourage entrepreneurial movement among rural community as to ensure business ideas flow. This research employed the quantitative method of data collection. The questionnaires were distributed to 500 local populations according to districts and villages. The findings of this study showed that both attitude (attitude toward money, attitude toward start-up influence entrepreneurial intention. The relationship between attitude toward start-up and entrepreneurial intention was mediated by opportunity recognition.

  9. [Medication use among community-dwelling older Icelanders. Population-based study in urban and rural areas].

    Science.gov (United States)

    Sigurdardottir, Arun K; Arnadottir, Solveig Asa; Gunnarsdottir, Elín Díanna

    2011-12-01

    To describe medication use among older community-dwelling Icelanders by collecting information on number of medicine, polypharmacy (>5 medications), and medications by ATC categories. Moreover, to explore the relationship between medication use and various influential factors emphasizing residency in urban and rural areas. Population-based, cross-sectional study. Participants were randomly selected from the National registry in one urban (n=118) and two rural (n=68) areas. 1) ≥ 65 years old, 2) community-dwelling, 3) able to communicate verbally. Information on medication use was obtained from each person's medication list and interviews. A questionnaire and five standardized instruments were used to assess the potential influencing factors. On average, participants used 3.9 medications and prevalence of polypharmacy was 41%. Men used 3.5 medications on average and women 4.4 (p=0.018). Compared to rural residents, urban residents had fewer medical diagnoses, better mobility, less pain, and fewer depressive symptoms. By controlling for the effects of these variables, more medications were associated with urban living (pbetter scores on health assessments.

  10. Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications--part II.

    Science.gov (United States)

    Woersching, Joanna C; Snyder, Audrey E

    2004-01-01

    Results reported in Part I of the Earthquakes in El Salvador series (see Disaster Management & Response 2003;1:105-9) indicated clinically relevant findings. The findings indicated a need for greater public health action within all five categories reviewed: healthcare, access to healthcare, housing, food, water and sanitation. Significant results between urban and rural communities indicated a need for broader community aid, public health and sanitation services to rural areas. Faster and more efficient disaster management and care services throughout the San Sebastian community were also necessary modifications.

  11. Analysis of the social network development of a virtual community for Australian intensive care professionals.

    Science.gov (United States)

    Rolls, Kaye Denise; Hansen, Margaret; Jackson, Debra; Elliott, Doug

    2014-11-01

    Social media platforms can create virtual communities, enabling healthcare professionals to network with a broad range of colleagues and facilitate knowledge exchange. In 2003, an Australian state health department established an intensive care mailing list to address the professional isolation experienced by senior intensive care nurses. This article describes the social network created within this virtual community by examining how the membership profile evolved from 2003 to 2009. A retrospective descriptive design was used. The data source was a deidentified member database. Since 2003, 1340 healthcare professionals subscribed to the virtual community with 78% of these (n = 1042) still members at the end of 2009. The membership profile has evolved from a single-state nurse-specific network to an Australia-wide multidisciplinary and multiorganizational intensive care network. The uptake and retention of membership by intensive care clinicians indicated that they appeared to value involvement in this virtual community. For healthcare organizations, a virtual community may be a communications option for minimizing professional and organizational barriers and promoting knowledge flow. Further research is, however, required to demonstrate a link between these broader social networks, enabling the exchange of knowledge and improved patient outcomes.

  12. Producing "science/fictions" about the rural and urban poor: Community-based learning at a medical college in South India

    Science.gov (United States)

    Arur, Aditi Ashok

    This dissertation is an ethnographic case study of a community-based teaching program (CBTP) in public health at a medical college in South India that explored how the CBTP produced particular ways of seeing and understanding rural and urban poor communities. Drawing from critical, feminist, and postcolonial scholars, I suggest that the knowledge produced in the CBTP can be understood as "science/fictions", that is, as cultural texts shaped by transnational development discourses as well as medical teachers' and students' sociospatial imaginations of the rural and urban poor. I explored how these science/fictions mediated medical students' performative actions and interactions with a rural and an urban poor community in the context of the CBTP. At the same time, I also examined how knowledge produced in students' encounters with these communities disrupted their naturalized understandings about these communities, and how it was taken up to renarrativize science/fictions anew. Data collection and analyses procedures were informed by critical ethnographic and critical discourse analysis approaches. Data sources includes field notes constructed from observations of the CBTP, interviews with medical teachers and students, and curricular texts including the standardized national textbook of public health. The findings of this study illustrate how the CBTP staged the government and technology as central actors in the production of healthy bodies, communities, and environments, and implicitly positioned medical teachers and students as productive citizens of a modern nation while rural and urban poor communities were characterized sometimes as empowered, and at other times as not-yet-modern and in need of reform. However, the community also constituted an alternate pedagogical site of engagement in that students' encounters with community members disrupted students' assumptions about these communities to an extent. Nevertheless, institutionalized practices of assessment

  13. The community-level effects of women's education on reproductive behaviour in rural Ghana

    Directory of Open Access Journals (Sweden)

    Kofi D. Benefo

    2006-06-01

    Full Text Available Using survey and census data for rural Ghana collected in the 1980s, this study examines the ability of women's education to increase interest in fertility regulation and contraception among all women, regardless of their individual and household features. The study finds that, net of her own characteristics, a woman's interest in limiting fertility and using modern contraception increase with the percent of educated women in her community. These results suggest that female education has a greater capacity to introduce novel reproductive ideas and behaviors into rural areas of Africa and thereby transform the demographic landscape in the region than is currently believed. There is also evidence that female education may undermine existing methods of regulating fertility. Other community characteristics that increase women's interest in regulating fertility and contraceptive use in this setting include access to transportation and proximity to urban areas. However, these are not as powerful as women's education in transforming reproductive behavior.

  14. Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Aagaard, Jørgen

    2015-01-01

    Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi-experime......Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi...... only. Results: Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P

  15. Associations between the social organization of communities and psychiatric disorders in rural Asia.

    Science.gov (United States)

    Axinn, William G; Ghimire, Dirgha J; Williams, Nathalie E; Scott, Kate M

    2015-10-01

    We provide rare evidence of factors producing psychiatric variation in a general population sample from rural South Asia. The setting is particularly useful for demonstrating that variations in the social organization of communities, often difficult to observe in rich countries, are associated with important variations in mental health. Clinically validated survey measures are used to document variation in psychiatric disorders among 401 adults. This sample is chosen from a systematic sample of the general population of rural Nepal, in a community-level-controlled comparison design. Multilevel logistic regression is used to estimate multivariate models of the association between community-level nonfamily social organization and individual-level psychiatric disorders. Schools, markets, health services and social support groups each substantially reduce the odds of depression, post-traumatic stress disorder (PTSD), intermittent explosive disorder and anxiety disorders. Associations between schools, health services and social support groups and depression are statistically significant and independent of each other. The association between access to markets and PTSD is statistically significant and independent of other social organization and support groups. Community integration of some nonfamily social organizations promotes mental health in ways that may go unobserved in settings with many such organizations. More research on the mechanisms producing these associations is likely to reveal potential avenues for public policy and programs to improve mental health in the general population.

  16. Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

    NARCIS (Netherlands)

    Havenaar, J.M.; Geerlings, M.I.; Vivian, L.; Collinson, M.; Robertson, B.

    2008-01-01

    This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

  17. Common mental health problems in historically disadvantaged urban and rural communities in South Africa : prevalence and risk factors

    NARCIS (Netherlands)

    Havenaar, Juhan M.; Geerlings, Mirjan I.; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

    This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

  18. A Community-based Bacteriological Study of Quality of Drinking-water and Its Feedback to a Rural Community in Western Maharashtra, India

    OpenAIRE

    Tambe, Prachi V.; Daswani, Poonam G.; Mistry, Nerges F.; Ghadge, Appasaheb A.; Antia, Noshir H.

    2008-01-01

    A longitudinal study of the bacteriological quality of rural water supplies was undertaken for a movement towards self-help against diseases, such as diarrhoea, and improved water management through increased community participation. Three hundred and thirteen water samples from different sources, such as well, tank, community standpost, handpumps, percolation lakes, and streams, and from households were collected from six villages in Maharashtra, India, over a one-year period. Overall, 49.8%...

  19. Individual, household, programme and community effects on childhood malnutrition in rural India.

    Science.gov (United States)

    Rajaram, S; Zottarelli, Lisa K; Sunil, T S

    2007-04-01

    The children living in rural areas of India disproportionately suffer from malnutrition compared with their urban counterparts. The present article analyses the individual, household, community and programme factors on nutritional status of children in rural India. Additionally, we consider the random variances at village and state levels after introducing various observed individual-, household- and programme-level characteristics in the model. A multilevel model is conducted using data from the National Family and Health Survey 2. The results show that maternal characteristics, such as socio-economic and behavioural factors, are more influential in determining childhood nutritional status than the prevalence of programme factors. Also, it was found that individual factors show evidence of state- and village-level clustering of malnutrition.

  20. Pharmacy and primary care perspectives on e-prescribing in a rural community: A focused ethnography.

    Science.gov (United States)

    Kooienga, Sarah; Singh, Reshmi L

    Electronic prescribing (ERx) is the ability for prescriber to send a digital prescription directly to a pharmacist through a dedicated secure network. A number of federally funded incentives such as the health information technology for economic and clinical health (HITECH) and Meaningful Use standards have led to ERx implementation. ERx is an integral part of primary care practice and today most community pharmacies are enabled to accept e-prescriptions. Little is known about the experience of rural pharmacists, primary care providers and patients regarding e-prescribing. This paper reports on the results of ERx from their perspectives. The findings are a portion of a larger qualitative descriptive study focused on the meaning of Meaningful Use in remote rural communities. One remote rural community in the Pacific Northwest was used for this research endeavor. Explore understandings of e-prescribing from both pharmacist and primary care provider perspective. Explore patients' understandings and experiences of e-prescribing. The conceptual model for this research was the Ecological Transactional Model. This model informed the research design, interview questions and analysis. A qualitative descriptive methodology - focused ethnography was used for this study. Six key informant interviews, 14 patient interviews and 15 hours of participant observation provided the data. Data analysis occurred collectively between a social pharmacy researcher, a primary care nurse practitioner-researcher and pharmacy graduate students. The research qualitatively identified contextual understandings and dimensions of ERx in this setting. Based on a focused ethnographic methodology, contextual understandings of rurality and role identity, both pharmacist and primary care provider, were explored. Perspectives on ERx of patients, clinic manager and RN staff were also elicited. Three dimensions of ERx were identified - technological, structural and communication. The structural