Reducing psychological distress and obesity in Australian farmers by promoting physical activity

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: This study is designed to examine the effect of physical activity on psychological health and other comorbidities such as obesity, impaired glucose tolerance, hypertension and dyslipidaemia within a high-risk cohort. The outcomes of this research will be relevant to further research and service delivery programs, in particular those tailored to rural communities.

Sizing solar home systems for optimal development impact

The paper compares the development impact of three different sized solar home systems (SHS) (10, 40 and 80 Wp) installed in rural East Timor. It describes research aimed to determine whether the higher cost of the larger systems was justified by additional household benefits. To assess the development impact of these different sizes of SHS the research used a combination of participatory and quantitative tools. Participatory exercises were conducted with seventy-seven small groups of SHS users in twenty-four rural communities and supplemented with a household survey of 195 SHS users.

The combined results of these evaluation processes enabled the three sizes of SHS to be compared for two types of benefits—those associated with carrying out important household tasks and attributes of SHS which were advantageous compared to the use of non-electric lighting sources. The research findings showed that the small, 10 Wp SHS provided much of the development impact of the larger systems. It suggests three significant implications for the design of SHS programs in contexts such as East Timor: provide more small systems rather than fewer large ones; provide lighting in the kitchen wherever possible; and carefully match SHS operating costs to the incomes of rural users.

Community social capital and entrepreneurship : analyzing the links

This study examines the effects of community social capital on entrepreneurial intentions (EIs) in rural communities in a developing country. Entrepreneurship, in the form of business start-ups, is widely recognized as an integral component of local economic development programs designed to address poverty and limited livelihood opportunities, especially among poor and marginalized communities in rural areas in developing countries. Using a survey of 496 individuals residing in five rural communities in the Philippines, and drawing from the theory of planned behavior and social capital theory, we examine the direct and indirect effects of community social capital (CSC) on an individual’s EIs. The findings show that CSC largely influences EI by shaping an individual’s perceived self-efficacy (PSE) to engage in entrepreneurship, perceived desirability of entrepreneurship (PDE), and perceived social norms toward entrepreneurship (PSNE). High levels of PSE, PDE, and PSNE have a positive influence on an individual’s EI. These findings offer more nuanced explanations of how social capital within a community can facilitate entrepreneurship as a means of community economic development. Implications of the findings and areas for future research are discussed.

Beacon of Hope? Lessons learned from efforts to reduce civilian deaths from police shootings in an Australian state

In the 1990s, the police service in Victoria, Australia, faced a crisis of community confidence due to a spate of civilian deaths from police shootings. In that decade, twice as many civilians died at the hands of the police in Victoria than in every other Australian state combined. Most of those killed were mentally ill and affected by drugs and alcohol, and were rarely a serious threat except to themselves. The problem was also almost entirely an urban phenomenon. Shootings in rural communities, where mentally ill people were more likely to be personally known to local police, were (and remain) almost unknown. The large number of fatalities was recognised as a serious threat to public confidence, and Victoria Police introduced a ground-breaking training programme, Operation Beacon. Operating procedures and weapons training were fundamentally changed, to focus on de-escalation of conflict and avoiding or minimising police use of force. In the short term, Operation Beacon was successful. Shooting incidents were dramatically reduced. However, during the first decade of the new century, the number of civilians being killed again increased. This article examines Operation Beacon, both as a successful model for reducing civilian deaths at the hand of police and as a cautionary tale for police reform. We argue that the lessons of Operation Beacon have been gradually forgotten and that old habits and attitudes resurfaced. Fatal shootings of mentally ill civilians can be prevented, but if success is to be other than temporary, the Beacon philosophy must be continually reemphasised by police management.

Underage purchasing of alcohol from packaged liquor outlets: an Australian study

Access to the supply of alcohol is an important factor influencing adolescent alcohol consumption. Although alcohol sales outlets are prohibited from selling alcohol to underage youth, there has been limited research investigating compliance. The present study sought to estimate the extent to which adolescents that appeared underage were successfully able to purchase alcohol from packaged liquor outlets in Australia; and to identify store and sales characteristics associated with illegal purchasing. In 2012, purchase surveys were conducted (n= 310) at packaged liquor outlets in 28 urban and rural communities across three states of Australia: Western Australia, Queensland and Victoria. Confederates successfully purchased alcohol at 60% (95% CI: 55-66) of outlets. The density of general alcohol outlets in the surrounding area and the type of liquor outlet were predictors of successful alcohol purchases; however, this was moderated by the state in which the purchase was made. Regional geographical location was also found to predict underage alcohol purchase. The majority of alcohol sales outlets in Australia breach regulations prohibiting sales to underage youth. Consistent enforcement of policies across the states of Australia, and reducing the number of alcohol outlets, will help prevent alcohol outlets illegally selling alcohol to underage adolescents.

Beyond community-based diabetes management and the COAG coordinated care trial

OBJECTIVE: This article describes the patient management processes developed during the Council of Australian Governments (COAG) coordinated care trial and use of health outcome measures to monitor changes in utilisation patterns and patient well-being over time for a subgroup of 398 patients with type 2 diabetes. DESIGN: The Eyre component of the South Australian (SA) HealthPlus coordinated care trial was a matched geographically controlled study in which the outcomes for the intervention group of 1350 patients were compared with those of a similar control group of 500 patients in another rural health region in SA. SETTING: The trial was carried out on Eyre Peninsula in SA across populations in rural communities and in the main centres of Whyalla, Port Lincoln and Ceduna. Care planning was organised through general practitioner practices and services negotiated with allied health services and hospitals to meet patient needs. SUBJECTS: The SA HealthPlus trial included 1350 patients with chronic and complex illness. A subset of this group comprising 398 patients with type 2 diabetes is described in this report. Patients recruited into the three-year trial were care planned using a patient centred care planning model through which patient goals were generated along with medical management goals developed by clinicians and primary health care professionals. Relevant health services were scheduled in line with best practice and care plans were reviewed each year. Patient service utilisation, progress towards achieving health related goals and patient health outcomes were recorded and assessed to determine improvements in health and well-being along with the cost and profile of the services provided. RESULTS: Significant numbers of patients experienced improved health outcomes as a consequence of their involvement in the trial, and utilisation data showed reductions in hospital and medical expenditure for some patients. These results suggest that methods applied in the SA HealthPlus coordinated care trial have led to improvements in health outcomes for patients with diabetes and other chronic illnesses. In addition, the processes associated with the COAG trial motivated significant organisational change in the Regional Health Service as well as providing an opportunity to study the health and well-being outcomes resulting from a major community health intervention. CONCLUSIONS: The importance of the SA HealthPlus trial has been the demonstrated link between a formal research trial and significant developments in the larger health system with the trial not only leading to improvements in clinical outcomes for patients, but also acting as a catalyst for organisational reform. We now need to look beyond the illness focus of health outcome research to develop population based health approaches to improving overall community well-being.

Garlic (Allium sativum): diet based therapy of 21st century-a review

Functional and nutraceutical foods provide an opportunity to improve one's health by reducing health care costs and to support economic development in rural communities. For this reason, various phyto-based functional foods are becoming popular worldwide owing to number of evidences for their safer therapeutic applications. Garlic (Allium sativum L.,) is an essential vegetable that has been widely utilized as seasoning, flavoring, culinary and in herbal remedies. The consumption of traditional plants especially garlic has progressively increased worldwide because of their great effectiveness, fewer side effects and relatively low cost. Garlic is well known to contain an array of phytochemicals. These bioactive molecules are playing pivotal role in maintaining human health and having potential to reduce various ailments. It has distinct nutritional profile with special reference to its various bioactive components that can be used in different diet based therapies to cure various life-style related disorders. The present review is an attempt to explore the functional/nutraceutical role of garlic against various threats including dyslipidemia and hyperglycemia, cardiovascular disorders, antioxidant capacity and carcinogenic perspectives.

Promoting critical thinking to high school students when teaching about climate change through a participatory approach

New paradigms in science education are focused on moving towards a sustainable society, meaning redefining the educational practices and developing new methods in order to establish better relationships among individuals, groups, and the society. Being able to reflect upon developing new pedagogic strategies, that support collective action, is crucial to favour social change. Education in the twenty-first century should be based on critical and social theories of the environment and development, in order to link the prospects for sustainability to new forms of economy, social welfare, governance and education (Barraza et al., Environ Educ Res 9(3):347-357, 2003). The nature of contemporary knowledge and knowledge construction demands increasing collaboration and communication between once isolated disciplines. Curriculum integration can reduce curriculum fragmentation, promoting a better awareness of the way different forms of knowledge work and contribute to collaborative knowledge construction, stimulating a critical and a reflexive perspective in their learners. This chapter will focus on the pedagogic strategies used in a research project aiming to provide potential young scientists from rural communities of Mexico and Alaska with a unique opportunity to learn more about their own local knowledge whilst gaining a better understanding of how it intersects with global processes. The project has helped students make cognitive links between their scientific knowledge and life experience, and has established affective and behavioral links which have intensified the ways in which they value their environment, culture, traditions and communities (Tytler et al. 2010; Bodenhorn, Learning about environmental research in a context of climate change: an international scholastic interchange (pilot project). Final report. BASC (Barrow Arctic Science Consortium)). The conjunction of collaborative, interdisciplinary work and multiple pedagogic strategies applied in this specific educational practice has shown the potential of implementing research group initiatives in science education. We believe that educational approaches that create spaces for students to work together towards a goal defined as a common good, can contribute significantly to develop effective science programs in schools.

Health extension workers' and mothers' attitudes to maternal health service utilization and acceptance in Adwa Woreda, Tigray Region, Ethiopia.

BACKGROUND: The maternal health system in Ethiopia links health posts in rural communities (kebeles) with district (woreda) health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs) assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs' and mother's attitudes to maternal health services in Adwa Woreda, Tigray Region. METHODS: In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women's social status and mobility; and women's perceptions of skilled birth attendant's care. All data were analyzed thematically. FINDINGS: There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women), and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women's Development Groups (WDGs), and referral by ambulance to health facilities either before a woman's Expected Due Date (EDD) or if labour started at home. CONCLUSION: With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women's groups to improve maternal health, thus reducing the need for emergency obstetric care in low-income countries.

Changing the place of birth from home to health facilities in Kafa Zone, Ethiopia

Women in rural and semi-urban Kafa Zone, Ethiopia are being encouraged to give birth in health facilities rather than at home. Using an earlier 2007 study as a comparison point, this study explored the role of Health Extension Workers (HEWs) in referring women to health centres for birth. Semi-structured interviews were conducted with 11 HEWs and 6 health workers in May and June 2014. The results show that women prefer birth attendants they know, including HEWs, and not to go to health centres or the hospital except for emergencies. The ambulance service linking rural communities with health facilities works better in some areas than others. To improve maternal health, HEWs need better support at the community level. Inefficiencies in the referral system should be addressed.

Struggles to subvert the gendered field: issues of masculinity, rurality and class

This article explores the complex struggles associated with intersections of class, rurality and masculinity, and the ways in which such intersections work to preserve a gendered status quo within and beyond school communities in Australia. Drawing on the stories of Monica and Phoebe, two teachers who understand schooling as a site of contestation, resistance and possibility for gender justice, the article draws on the theoretical constructs of Bourdieu to make visible the struggles for power arising from the gendered distribution of capital in schools located in low socio‐economic rural communities. In making sense of these struggles, we identify strategies of conservation that seek to reinscribe gender inequities and preserve the field and the taken‐for‐granted understandings of females and femininity as subordinate to males and masculinity within it. We also identify pedagogies of subversion employed by Phoebe and Monica and highlight the potential of these practices to disrupt the field in ways that seek to broaden and transform the gendered habitus of students.

Maturing school-community partnerships : developing learning communities in rural Australia

This paper reports findings from a project that examined the extent and nature of the contribution of rural schools to their communities’ development beyond traditional forms of education of young people. Case study communities in five Australian States participated in the project, funded by the Rural Industries Research and Development Corporation. Communities and schools that share the belief that education is the responsibility of the whole community and work together, drawing on skills and knowledge of the community as a whole, experience benefits that extend far beyond producing a well-educated group of young people. The level of maturity of the school– community partnership dictates how schools and communities go about developing and sustaining new linkages, or joint projects. Twelve characteristics central to the success of school–community partnerships were identified. The characteristics are largely sequential in that later characteristics build on earlier ones. Underscoring these characteristics is the importance of collective learning activities including teamwork and network building, which have been identified elsewhere as key social capital building activities. A generic model of the relationship between the indicators of effective school–community partnerships and the level of maturity of those partnerships is forwarded.