983 resultados para Rural hospitals
Resumo:
The strategies and techniques that police officers employ are adaptations to the types of communities they serve and the law enforcement system of which they are part. Observations of policing in rural and urban areas of Australia indicate that, despite being part of a single state police service, officers develop working philosophies that are systematically adapted to the locations they serve. Bayley (1989) has observed that while crimes are policed in the city, people are policed in the country. Rural police officers often adopt a community-based model of policing in which officers become integrated into a community and establish compatible community relations. While this model can produce successful results, with integration into informal social networks providing police increased opportunities to solve crime, rural police regularly find themselves occupying competing roles of law enforcer and local resident. This chapter will outline how the organisation and structure of rural communities impacts upon policing, noting distinct issues associated with police work in rural settings. Before examining current aspects of rural policing, a brief discussion of the historical and cultural context of rural policing is provided.
Introduction - There's crime out there, but not as we know it: Rural criminology - the last frontier
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The idea that crime is a predominantly urban phenomenon has been pervasive in criminology, so much so that Australian criminology textbooks do not recognise rural crime as a distinct phenomenon worthy of scholarly attention (see Chappell & Wilson, 2000; Goldsmith et al, 2003; White & Haines, 2004; White & Habibis, 2005). There are no chapters or sections in Australian texts which specifically examine rural crime, despite the inclusion of a range of topics that appear to provide a broad coverage of crime in its many temporal and spatial dimensions. Nor is there so much as an index reference to "rural" issues in criminology textbooks. The standardised syllabus for crime texts provides coverage of topics such as violent crime, public crime, delinquency, race and crime, gender and crime, and crime and social class. This canon is mirrored in international texts, most of which also fail to address the issue of rural crime, but make abundant reference to crime in various urban contexts (see Carrabine et al, 2004; Conklin, 2004). This is not to suggest that Australian texts fail to localise their subject matter.
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During the last decade 'prostitution' has been characterised as a 'social problem' throughout rural and regional New South Wales. As we show here, the urban-centric nature of popular and official discourses of prostitution have inadvertently allowed for the development of regulatory positions which have negatively impacted sex workers in rural and regional communities and lead to conflict among sectors of the rural sex industry and between the sex industry and community activists. In addition to examining the problematisation of sex work in rural New South Wales, this paper sets out to understand why rural sex work has historically lacked visibility in popular and scholarly discourses. We provide an overview of the distinctive organisational aspects of the sex industry in rural contexts. Evidence for our assertions is largely derived from primary interview data collected from sex industry workers based in rural New South Wales. The paper represents the first attempt in the research literature on prostitution to understand sex work as a rural phenomenon.
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The paper reports health related findings of the first study undertaken of rural sex workers in an income-rich nation. In-depth interviews were conducted with eighteen purposively selected women who work in the rural sex industry. Rural sex services have a unique structure which informs the experiences of sex workers. Recent advances in telecommunications technology have impacted upon the organisation and structure of the sex industry in rural environments. Notable has been the growth of escort services in rural areas, which has diversified the rural sex industry from its traditional base of brothel operations. The general absence of street prostitution in rural settings has meant that the profile of rural sex workers tends to resemble that of escorts or call girls in urban settings, with workers having a relatively high level of control over working conditions and compliance with public health initiatives. Important issues which impact upon the rural sex industry include confidentiality and the more limited market for sexual services likely to be encountered in rural settings. These issues may impact on the sexual health of rural sex workers in terms of risk practices and access to health services.
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Drawing upon sociology of work, feminist theory and past sex worker research, we present the first study to explore the sex work industry in rural Australia. Using qualitative data from interviews conducted December 2004 - February 2005 with 20 sex industry workers in New South Wales, we question existing assumptions and generalizations surrounding contemporary sex work to explore how industry workers perceive their career experiences. Specifically, we explore workers’ motivations for entering and continuing to be involved in the industry, the profession benefits and historical changes. In contrast to radical feminist theory’s equation of sex work with victimization, these narratives by rural sex workers portray experiences of sexual empowerment, economic advancement, job flexibility, achievement and examples of positive social interaction. In conclusion, our findings provide contrasting data to the sex politics surrounding “prostitution” put forth by radical feminists as we reaffirm the sex industry to be a legitimate career option in rural Australia and challenge the determinism used to labelled sex work as definitively degrading and deleterious to women.
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The research explores the potential for participatory and collaborative approaches in working with the Indonesian glass-bead rural craft industry, which currently struggles to sustain its business. Contextual inquiry and participatory action research were used to understand the local context, including motivations, barriers and opportunities and to collaboratively develop strategies for advancement and innovation. The study documents participatory design projects undertaken to make, sell and promote hedonic products. It identifies the importance of understanding local context and individual craftsperson aspirations in designing collaborative support programs. It also provides an in depth insight into the Indonesian rural craft industry.
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Objective: In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. Methods: The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. Results: The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Conclusions: Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. What is known about the topic? The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare-Associated Infections) of the National Safety and Quality Health Service Standards. The intent of AMS is to ensure appropriate prescribing of antimicrobials as part of the broader systems within a health service organisation to prevent and manage healthcare-associated infections, and improve patient safety and quality of care. This criterion also aligns closely with Standard 4: Medication Safety. Despite this recommendation, little is known about what AMS activities are undertaken in these facilities and what additional resources would be required in order to meet these national standards. What does the paper add? This is the first survey that has been conducted of public hospital and health services in Queensland, a large decentralised state in Australia. This paper describes what AMS activities are currently being undertaken, identifies practice gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. What are the implications for practitioners? Several areas for improvement such as reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use have been identified. In addition, there appears to be a lack of resources to support AMS programs in some facilities.
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Hospitals invest considerable resources organizing operating suites and having surgeons and theatre staff available on an agreed schedule. A common impediment to efficiency is perioperative delay,including delays getting to the operating room or during the operation. Perioperative delays entail significant costs for hospitals,wasting staff time and operating theatre resources. They may also affect patient outcomes; prolonged surgery is a predictor for unanticipated admission following elective ambulatory surgery...
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While many Australian hospitals have good infection control practices, research about the role cleaning in the hospital environment plays in preventing infections is limited.
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Objectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters. Design A surveillance study of incidence and mortality. Linked data from two public health surveillance systems were analysed. Setting Three selected counties in Shandong, China. Participants All residents in the three selected counties. Outcome measures Incidence rate ( per 100 000 person-years) and case fatality rate (%). Methods Records of suicide deaths and hospitalisations that occurred among residents in selected counties during 2009–2011 (5 623 323 person-years) were extracted from electronic databases of the Disease Surveillance Points (DSP) system and the Injury Surveillance System (ISS) and were linked by name, sex, residence and time of suicide attempt. A multiple logistic regression model was developed to examine the factors associated with a higher or lower fatality rate. Results The incidence of SSAs was estimated to be 46 (95% CI 44 to 48) per 100 000 person-years, which was 1.5 times higher in rural versus urban areas, slightly higher among females, and increased with age. Among all SSAs, 51% were hospitalised and survived, 9% were hospitalised but later died and 40% died with no hospitalisation. Most suicide deaths (81%) were not hospitalised and most hospitalised SSAs (85%) survived. The fatality rate was 49% overall, but was significantly higher among attempters living in rural areas, who were male, older, with lower education or with a farming occupation. With regard to the method of suicide, fatality was lowest for non-pesticide poisons (7%) and highest for hanging (97%). Conclusions The incidence of serious suicide attempts is substantially higher in rural areas than in urban areas of China. The risk of death is influenced by the attempter’s sex, age, education level, occupation, method used and season of year.
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This article uses the concept of the architecture of rural life to analyse domestic violence service provision in rural Australia. What is distinctive about this architecture is that it polices the privacy of the rural family. A tight cloak of silence is carved around instances of domestic violence. Imagined threats to rural safety are seen as coming from outsiders (i.e. urban influences or Indigenous), not insiders within rural families. This article draws on key findings from a study conducted in rural New South Wales, Australia. The study interviewed 49 rural service providers working in human services and the criminal justice system. The application of architecture of rural life as a conceptual tool demonstrates challenges with service provision in a rural setting. The main results of this study found that this architecture operates as a silencing form of social control in three distinctive ways. Firstly, shame about being a victim of domestic violence encourages rural women's complicity in remaining silent. Secondly, family privacy maintains a veil of silence that accentuates rural women's social and economic dependency on men. Thirdly, community sanctions act as a deterrent to women seeking help.
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Background The frequency of prescribing potentially inappropriate medications (PIMs) in older patients remains high despite evidence of adverse outcomes from their use. Little is known about whether admission to hospital has any effect on appropriateness of prescribing. Objectives This study aimed to identify the prevalence and nature of PIMs and explore the association of risk factors for receiving a PIM. Methods This was a prospective study of 206 patients discharged to residential aged care facilities (RACFs) from acute care. All patients were aged at least 70 years and were admitted between July 2005 and May 2010; their admission and discharge medications were evaluated. Results Mean patient age was 84.8 ± 6.7 years; the majority (57%) were older than 85 years and mean (SD) Frailty Index was 0.42 (0.15). At least one PIM was identified in 112 (54.4%) patients on admission and 102 (49.5%) patients on discharge. Of all medications prescribed at admission (1728), 10.8% were PIMs and at discharge of 1759 medications, 9.6% were PIMs. Of total 187 PIMs on admission, 56 (30%) were stopped and 131 were continued; 32 new PIMs were introduced. Of the potential risk factors considered, in-hospital cognitive decline and frailty status were the only significant predictors of PIMs. Conclusion Although, admission to hospital is an opportunity to review the indications for specific medications, a high prevalence of inappropriate drug use was observed. The only associations with PIM use were the frailty status and in-hospital cognitive decline. Additional studies are needed to further evaluate this association.
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Rural crime has largely been understood through social disorganization theory. The dominance of this perspective has meant that most research into rural crime has tried to resolve perceived strains in communities, rather than analyze how social problems are constituted in rural places. Using Elias and Scotson's (1994) account of established-outsider relations, the paper examines how the organizational capacity of specific social groups is significant in determining the quality of crime-talk and responses to crime in isolated and rural settings. In particular social 'oldness' and notions of what constitutes 'community' are significant in determining what activities and individuals or groups are marked as features of crime-talk in these settings.
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The rapid pace of urbanisation in China has seen a massive increase in the movement of the rural population to work and live in urban regions. In this large-scale migration context, the educational, health, and psychological problems of floating children are becoming increasingly visible. Different from extant studies, we focus our investigation on the rural dispositions of floating children through interviews with leaders, teachers, and students in four schools in Beijing. Drawing on Bourdieu’s key notions of habitus, capital, and field, our study indicates that the rural habitus of floating children can differentiate these children from their urban peers. This habitus can be marginalised and stigmatised in certain fields but can be recognised and valued as capital in other fields. Our paper offers some implications for research and practice in relation to the schooling of floating children.
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Australia faces an ongoing challenge recruiting professionals to staff essential human services in rural and remote communities. This paper identifies the private limits to the implicit service contract between professions and such client populations. These become evident in how private solutions to competing priorities within professional families inform their selective mobility and thus create the public problem for such communities. The paper reports on a survey of doctors, nurses, teachers and police with responsibility for school-aged children in Queensland that plumbed the strength of neoliberal values in their educational strategy and their commitment to the public good in career decisions. The quantitative analysis suggested that neoliberal values are not necessarily opposed to a commitment to the public good. However, the qualitative analysis of responses to hypothetical career opportunities in rural and remote communities drew out the multiple intertwined spatial and temporal limits to such public service, highlighting the priority given to educational strategy in these families’ deliberations. This private/public nexus poses a policy problem on multiple institutional fronts.