Urban pre-service teachers’ conceptions of teaching in rural communities

Encouraging quality teaching staff to apply for and accept teaching placements in rural and remote locations is an ongoing concern internationally. The value of different support mechanisms provided for pre-service teachers attending a rural and remote practicum[1] are investigated through theories of place and the school-community nexus. Qualitative data regarding the experiences of the pre-service teachers were collected through interviews and case study notes. This project adds to our understanding of practicum in rural areas by employing a conceptual understanding of place to propose how the experiences of a four-week practicum may contribute to urban pre-service teachers’ conceptions of work and life in a rural community

A potential HIV epidemic among male street laborers in urban Vietnam

Background: Mass migration to Asian cities is a defining phenomenon of the present age, as hundreds of millions of people move from rural areas or between cities in search of economic prosperity. Although many do prosper, large numbers of people experience significant social disadvantage. This is especially the case among poorly educated, migrant unskilled unregistered male laborers who do much of the manual work throughout the cities. These men are at significant risk for many health problems, including HIV infection. However, to date there has been little research in developing countries to explain the determinants of this risk, and thereby to suggest feasible preventive strategies. Objectives and Methodology: Using combined qualitative and quantitative methods, the aim of this study was to explore the social contexts that affect health vulnerabilities and to develop conceptual models to predict risk behaviors for HIV [illicit drug use, unsafe sex, and non-testing for HIV] among male street laborers in Hanoi, Vietnam. Qualitative Research: Sixteen qualitative interviews revealed a complex variety of life experiences, beliefs and knowledge deficits that render these mostly poor and minimally educated men vulnerable to health problems including HIV infection. This study formed a conceptual model of numerous stressors related to migrants’ life experiences in urban space, including physical, financial and social factors. A wide range of coping strategies were adopted to deal with stressors – including problem-focused coping (PFC) and emotion-focused coping (EFC), pro-social and anti-social, active and passive. These men reported difficulty in coping with stressors because they had weak social networks and lacked support from formal systems. A second conceptual model emerged that highlighted equivalent influences of individual psychological factors, social integration, social barriers, and accessibility regarding drug use and sexual risk behavior. Psychological dimensions such as tedium, distress, fatalism and revenge, were important. There were strong effects of collective decision-making and fear of social isolation on shaping risk behaviors. These exploratory qualitative interviews helped to develop a culturally appropriate instrument for the quantitative survey and informed theoretical models of the factors that affect risk behaviors for HIV infection. Quantitative Research: The Information-Motivation-Behavioral Skills (IMB) model was adopted as the theoretical framework for a large-scale survey. It was modified to suit the contexts of these Vietnamese men. By doing a social mapping technique, 450 male street laborers were interviewed in Hanoi, Vietnam. The survey revealed that the risk of acquiring and transmitting HIV was high among these men. One in every 12 men reported homosexual or bisexual behavior. These men on average had 3 partners within the preceding year, and condom use was inconsistent. One third had had sex with commercial sex workers (CSW) and only 30% of them reported condom use; 17% used illicit drugs sometimes, with 66.7% of them frequently sharing injecting equipment with peers. Despite the risks, only 19.8% of men had been tested for HIV during the previous 12 months. These men have limited HIV knowledge and only moderate motivation and perceived behavioral skills for protective behavior. Although rural-to-urban migration was not associated with sexual risk behavior, three elements of the IMB model and depression associated with the process of mobility were significant determinants of sexual behavior. A modified model that incorporated IMB elements and psychosocial stress was found to be a better fit than the original IMB model alone in predicting protected sex behavior among the men. Men who were less psychologically and socially stressed, better informed and motivated for HIV prevention were more likely to demonstrate behavioral skills, and in turn were more likely to engage in safer sexual behavior. With regard to drug use, although the conventional model accounted for slightly less variance than the modified IMB model, data were of better fit for the conventional model. Multivariate analyses revealed that men who originated from urban areas, those who were homo- or bi-sexually identified and had better knowledge and skills for HIV prevention were more likely to access HIV testing, while men who had more sexual partners and those who did not use a condom for sex with CSW were least likely to take a test. The modified IMB model provided a better fit than the conventional model, as it explained a greater variance in HIV testing. Conclusions and Implications: This research helps to highlight a potential hidden HIV epidemic among street male, unskilled, unregistered laborers. This group has multiple vulnerabilities to HIV infection through both their partners and peers. However, most do not know their HIV status and have limited knowledge about preventing infection. This is the first application of a modified IMB model of risk behaviors for HIV such as drug use, condom use, and uptake of HIV testing to research with male street laborers in urban settings. The study demonstrated that while the extended IMB model had better fit than the conventional version in explaining the behaviors of safe sex and HIV testing, it was not so for drug use. The results provide interesting directions for future research and suggest ways to effectively design intervention strategies. The findings should shed light on culturally appropriate HIV preventive education and support programs for these men. As Vietnam has much in common with other developing countries in Southeast Asia, this research provides evidence for policy and practice that may be useful for public health systems in similar countries.

Becoming Partners: Partnerships reshaping preservice teachers’ preparation to teach in rural Queensland schools

Preparing preservice teachers for successful rural and remote teaching is an ongoing and significant issue that impacts on equity issues for Australian students (Sharplin, 2002) and the sustainability of rural communities (Green & Reid, 2004). Improving the preparation of preservice teachers for teaching in rural schools is a key recommendation from the Human Rights and Equal Opportunity Commission (2000). This presentation analyses how an innovative partnership between a teacher employer and a teacher education institution as a response to a mandated reform within the Improving Teacher Quality National Partnership Agreement has been established to address the important need to prepare and recruit preservice teachers to teach in rural and remote areas of Queensland.

Urban, suburban, and rural variations in separation/divorce rape/sexual assault : results from the National Crime Victimization Survey

To date, no large study has looked at whether separation/divorce sexual assault varies across urban, suburban, and rural areas. The authors use 1992-2009 NCVS (National Crime Victimization Survey) data to estimate the percentage of separation/divorce sexual assault against women in urban, suburban, and rural communities. In addition, the authors identify and compare the relative risk of sexual assault victimization for women across areas. Findings indicate that a higher percentage of rural divorced/separated women were victims of rape/sexual assault than were urban divorced/separated women. In addition, rural separated women are victims of intimate rape/sexual assault at significantly higher rates than their suburban and urban counterparts.

Challenges for researchers investigating contraceptive use and pregnancy intentions of young women living in urban and rural Australia : face-to-face discussions to increase participation in a web-based survey

Background: It is imperative to understand how to engage young women in research about issues that are important to them. There is limited reliable data on how young women access contraception in Australia especially in rural areas where services may be less available. Objective: This paper identifies the challenges involved in engaging young Australian women aged 18-23 years to participate in a web-based survey on contraception and pregnancy and ensure their ongoing commitment to follow-up web-based surveys. Methods: A group of young women, aged 18-23 years and living in urban and rural New South Wales, Australia, were recruited to participate in face-to-face discussions using several methods of recruitment: direct contact (face-to-face, telephone or email)and snowball sampling by potential participants inviting their friends. All discussions were transcribed verbatim and analyzed using thematic analysis. Results: Twenty young women participated (urban, n=10: mean age 21.6 years; rural, n=10: 20.0 years) and all used computers or smart phones to access the internet on a daily basis. All participants were concerned about the cost of internet access and utilized free access to social media on their mobile phones. Their willingness to participate in a web-based survey was dependent on incentives with a preference for small financial rewards. Most participants were concerned about their personal details and survey responses remaining confidential and secure. The most appropriate survey would take up to 15 minutes to complete, be a mix of short and long questions and eye-catching with bright colours. Questions on the sensitive topics of sexual activity, contraception and pregnancy were acceptable if they could respond with “I prefer not to answer”. Conclusions: There are demographic, participation and survey design challenges in engaging young women in a web-based survey. Based on our findings, future research efforts are needed to understand the full extent of the role social media and incentives play in the decision of young women to participate in web-based research.

Suicide rates in Shandong, China, 1991–2010 : rapid decrease in rural rates and steady increase in male–female ratio

Background China has one of the highest suicide rates in the world; however, the recent trends in suicide have not been adequately studied. This study aimed to examine the potential changes in the rates and characteristics in a Chinese population. Methods Data on suicide deaths in 1991–2010 were extracted from the Shandong Disease Surveillance Point (DSP) mortality dataset based on ICD-10 codes. The temporal trend in age-adjusted suicide rates for each subpopulation was tested using log-linear Poisson regression analysis. Results From 1991 to 2010, there was a marked decrease in the overall suicide rate in Shandong, with an average reduction of 8% per year. The decrease trend was stronger in rural than in urban areas and more evident in females than in males. Similar decreases were observed for all age groups. Pesticide ingestion and hanging remained the top two methods for suicide. Limitations There are likely quality concerns in the morality data, such as underreporting and misclassification, as well as low accuracy in determining the underlying causes of deaths. The representativeness of the DSP system may also be problematic due to the rapid changes in economy and demography. Conclusions Completed suicides in Shandong have sharply declined over the past 20 years. Higher rates in females versus males and in rural versus urban areas, which were previously considered to be distinguishing features of suicide in China, are becoming less pronounced.

Remote, rural, and regional airports in Australia

This paper provides an overview of the challenges faced by remote, rural and regional airports in Australia. The deregulation of airports over the past decades has resulted in local councils owning most of the rural and regional airports across Australia. The paper provides an overview of the international literature on regional airports and research directed at defining the issues faced by regional and rural airports in Australia. A survey of airport managers, regulators and local councils was undertaken across Australia to outline the challenges and stresses that regional airports are facing. Core findings indicate that the operation of rural and regional airports is under stress due to the interrelating factors of infrastructure costs, high cost of maintenance, and security infrastructure upgrades. Small airports often compete with one another to attract airlines and maintain their infrastructure advantage.

A qualitative investigation into the different health experiences of people living with type II diabetes, in the rural environments

Study Rationale The objective of the study was to explore if and how rural culture influences type II diabetes management and to better understand the social processes that rural people construct in coping with diabetes and its complications. In particular, the study aimed to analyse the interface and interactions between rural people with type II diabetes and the Australian health care system. Theoretical framework and methods The research applied constructivist grounded theory methods within an interpretive interactionist framework. Data from 39 semi-structured interviews with rural and urban people with type II diabetes plus a mix of rural health care providers were analysed to develop a theoretical understanding of the social processes that define diabetes management in that context. Results The analysis suggests that although type II diabetes imposes limitations that require adjustment and adaptation these processes are actively negotiated by rural people within the environmental context to fit the salient social understandings of autonomy and self-reliance. Thus people normalised self-reliant diabetes management behaviours because this was congruent with the rural culture. Factors that informed the actions of normalisation were the relationships between participants and health care professions, support and access to individual resources. Conclusions The findings point to ways in which rural self-reliance is conceived as the primary strategy of diabetic management. People face the paradox of engaging with a health care system that at the same time maximises individual responsibility for health and minimises the social support by which individuals manage the condition. The emphasis on self-reliance gives some legitimacy to a lack of prevention and chronic care services. Success of diabetic management behaviours is contingent on relative resources. Where there is good primary care there develop a number of downstream effects including a sense of empowerment to manage difficult rural environmental circumstances. This has particular bearing on health outcomes for people with fewer resources.

Australian new graduate experiences during their transition program in a rural/regional acute setting

The transition process from student to Registered Nurse has been recognised as an important yet challenging time for newly graduated nurses. Knowledge about this experience from the nurse’s perspective, particularly in a rural setting, is limited. This paper reports the findings of a qualitative study of the experiences of newly graduated nurses working in a rural acute care facility in New South Wales. The study examined, from the perspective of the new nurse, the orientation and support which can help to facilitate the transition from student to registered nurse. Four themes emerged which were being supported, being challenged, reflections on being a new graduate, and reflections on a rural new graduate program. These findings contribute to what is know about the transition of new graduates in a rural facility and have implications for program improvements, specifically within the rural acute care environment. The findings are also relevant to students considering rural employment on graduation and for the recruitment and retention of New Graduate Registered Nurses in rural areas.

Experience of overseas-trained health professionals in rural and remote areas of destination countries: A literature review

This study aimed to review and synthesise existing literature that investigated the experience of overseastrained health professionals (OTHPs) in rural and remote areas of destination countries. A systematic literature review was conducted using electronic databases and manual search of studies published from January 2004 to February 2011. Data were analysed from the final 17 original report articles that met the inclusion criteria. The reviewed research studies were conducted in Australia, Canada, New Zealand, the UK and the USA. Overseas-trained medical practitioners were the most frequently researched (n = 14); two studies involved nurses and one study included several health professionals. Three main themes emerged from the review and these were: (i) expectations; (ii) cultural diversity; and (iii) orientation and integration to rural and remote health work environment. The OTHPs were expected to possess the appropriate professional and cultural skills while they themselves expected recognition of their previous experiences and adequate organisational orientation and support. A welcoming and accepting community coupled with a relaxed rural lifestyle and the joy of continued patient care resulted in successful integration and contributed to increased staff retention rates. Recognition of expectations and cultural diversity by all parties and comprehensive orientation with sufficient organisational support are important elements in the integration of OTHPs and subsequent delivery of quality health care to people living in rural and remote areas.

Telephone support to rural and remote patients with heart failure : the Chronic Heart failure Assessment by Telephone (CHAT) study

Background Heart failure (HF) remains a condition with high morbidity and mortality. We tested a telephone support strategy to reduce major events in rural and remote Australians with HF, who have limited healthcare access. Telephone support comprised an interactive telecommunication software tool (TeleWatch) with follow-up by trained cardiac nurses. Methods Patients with a general practice (GP) diagnosis of HF were randomised to usual care (UC) or UC and telephone support intervention (UC+I) using a cluster design involving 143 GPs throughout Australia. Patients were followed for 12 months. The primary end-point was the Packer clinical composite score. Secondary end-points included hospitalisation for any cause, death or hospitalisation, as well as HF hospitalisation. Results Four hundred and five patients were randomised into CHAT. Patients were well matched at baseline for key demographic variables. The primary end-point of the Packer Score was not different between the two groups (P=0.98), although more patients improved with UC+I. There were fewer patients hospitalised for any cause (74 versus 114, adjusted HR 0.67 [95% CI 0.50-0.89], p=0.006) and who died or were hospitalised (89 versus 124, adjusted HR 0.70 [95% CI 0.53 – 0.92], p=0.011), in the UC+I vs UC group. HF hospitalisations were reduced with UC+I (23 versus 35, adjusted HR 0.81 [95% CI 0.44 – 1.38]), although this was not significant (p=0.43). There were 16 deaths in the UC group and 17 in the UC+I group (p=0.43). Conclusions Although no difference was observed in the primary end-point of CHAT (Packer composite score), UC+I significantly reduced the number of HF patients hospitalised amongst a rural and remote cohort. These data suggest that telephone support may be an efficacious approach to improve clinical outcomes in rural and remote HF patients.

A phenomenological study of dream interpretation among the Xhosa-speaking people in rural South Africa

Psychologists investigating dreams in non-Western cultures have generally not considered the meanings of dreams within the unique meaning-structure of the person in his or her societal context. The study was concerned with explicating the indigenous system of dream interpretation of the Xhosa-speaking people, as revealed by acknowledged dream experts, and elaborating upon the life-world of the participants. Fifty dreams and their interpretations were collected from participants, who were traditional healers and their clients. A phenomenological methodology was adopted in explicating the data. Themes explicated included : the physiognomy of the dreamer's life-world as revealed by significant dreams, the interpretation of significant dreams as revealed through action, and human bodiliness as revealed in dream interpretations. The participants' approach to dreams is not based upon an explicit theory, but upon an immediate and pathic understanding of the dream phenomenon. The understanding is based upon the interpreter's concrete understanding of the life-world, which includes the possibility of cosmic integration and continuity between personal and trans-personal realms of being

Challenging Mining Workforce Practices : Implications for Frontline Rural Communities

Global demand for minerals and energy products has fuelled Australia’s recent ‘resources boom’ and led to the rapid expansion of mining projects not solely in remote regions but increasingly in long-settled traditionally agriculture-dependent rural areas. Not only has this activity radically changed the economic geography of the nation but a fundamental shift has also occurred to accommodate the acceleration in industry labour demands. In particular, the rush to mine has seen the entrenchment of workforce arrangements largely dependent on fly-in, fly-out (FIFO) and drive–in, drive–out (DIDO) workers. This form of employment has been highly contentious in rural communities at the frontline of resource sector activities. In the context of structural sweeping changes, the selection of study locations informed by a range of indices of violence. Serendipitously we carried out fieldwork in communities undergoing rapid change as a result of expanding resource sector activities. The presence of large numbers of non-resident FIFO and DIDO workers was transforming these frontline communities. This chapter highlights some implications of these changes, drawing upon one particular location, which historically depended on agriculture but has undergone redefinition through mining.