Educating Practitioners for Integrative Rural Practice

Arguably, living and working in rural communities can pose significant challenges for human service practitioners - challenges that are different from those encountered by their urban counterparts. Human services employers, like many other employers in rural areas, have difficulty in recruiting and retaining staff. There is now considerable evidence to support the notion that rural and remote practice constitutes a different and distinct form of practice and has undergone significant changes over the past decade. Living and working in rural communities means that practitioners are not only influenced by the rural and remote context of practice, they are also part of that context. Given the difficulty encountered in attracting and retaining rural practitioners and the changes in this area, an important question which emerges is: How can practitioners best be prepared for this work through largely urban based social work and human service education? The multifaceted and multilayered complexities in rural practice requires creativity, improvisation and a capacity for 'integrative thinking' (Martinez-Brawley 2002). This paper discusses six elements of newer forms of rural and remote practice and how they might be most effectively addressed through social work and human service curricula. An education model which integrates these elements and other principles for rural practice is proposed.

Do rural consumers expect a prescription from their GP visit? Investigation of patients' expectations for a prescription and doctors' prescribing decisions in rural Australia

Objective: To assess patients’ expectation for receiving a prescription and GPs’ perceptions of patient expectation for a prescription. Design: Matched questionnaire study completed by patients and GPs. Setting: Seven general practices in rural Queensland, Australia. Subjects: The subjects were 481 patients consulting 17 GPs. Main outcome measures: Patients’ expectation for receiving a prescription and GPs’ perceptions of patients’ expectation. Results: Ideal expectation (hope) for a prescription was expressed by 57% (274/481) of patients. Sixty-six per cent (313/481) thought it was likely that the doctor would actually give them a prescription. Doctors accurately predicted hope or lack of hope for a prescription in 65% (314/481) of consultations, but were inaccurate in 19% (93/481). A prescription was written in 55% of consultations. No increase in patients’ expectation, doctors’ perceptions of expectation, or decision to prescribe were detected for patients living a greater distance from the doctors. Conclusions: Rural patients demonstrated similar rates of hope for a prescription to those found in previous urban studies. Rural doctors seem to be similarly ‘accurate’ and ‘inaccurate’ in determining patients’ expectations. Rates of prescribing were comparable to urban rates. Distance was not found to increase the level of patient expectation, affect the doctors’ perception or to influence the decision to prescribe.

The role of migration in urban transition : studies of the relationship between migration and modernisation for Brisbane and Stockholm

Wilbur Zelinsky formulated a Hypothesis of Mobility Transition in 1971,in which he tried to relate all aspects of mobility to the Demographic Transition and modernisation. This dissertation applies the theoretical framework, proposed by Zelinsky and extended to encompass a family of transitions, to understand migration patterns of city regions. The two city regions, Brisbane and Stockholm, are selected as case studies, representing important city regions of similar size, but drawn from contrasting historical settings. A comparison of the case studies with the theoretical framework aims to determine how the relative contributions of net migration, the source areas of migrants, and the migration intensity change with modernisation. In addition, the research also aims to identify aspects of modernisation affecting migration. These aspects of migration are analysed with a "historical approach" and a "multivariate approach". An extensive investigation into the city regions' historical background provides the source, from which evidence for a relationship between migration and modernisation is extracted. With this historical approach, similarities and differences in migration patterns are identified. The other research approach analyse multivariate data, from the last two decades, on migration flows and modernisation. Correlations between migration and key aspects of modernisation are tested with multivariate regression, based on an alternative version of a spatial interaction model. The project demonstrates that the changing functions of cities and the structural modernisation are influential on migration. Similar patterns are found, regarding the relative contributions of net migration and natural increase to population growth. The research finds links between these changes in the relative contribution of net migration and demographic modernisation. The findings on variations in urban and rural source areas of migrants to city regions do not contradict the expected pattern, but data limitations prevent definite conclusion to be drawn. The assessment of variations in migration intensity resulted in the expected pattern not being supported. Based on Swedish data, the hypothesised increase in migration intensity is rejected. Interactional migration data also show patterns different from those derived from the theoretical framework. The findings, from both research approaches, suggested that structural modernisation affected migration flows more than demographic modernisation. The findings lead to a formulation of hypothesised patterns for migration to city regions. The study provides an important research contribution by applying the two research approaches to city regions. It also combines the study of internal and international migration to address the research objectives within a framework of transitional change.

Crisis and institutional change in urban governance

Recent studies of new institutional spaces typically underplay the uneven and contested process of institutional change by undervaluing the role of inherited institutions and discourses. This is a critical issue as neoliberal networked forms of governance interact with inherited institutional arrangements, characterised by important path dependencies that guide actors. Contradiction and tensions can emerge, culminating in crisis tendencies, and producing both discursive and material contestation between actors. It is with an understanding of path dependencies, ideas (structured into discourses), and (perceived and actual) crisis tendencies that this paper examines contested institutional change through a case-study analysis of one city, and a critical engagement with neoinstitutionalism. The purpose is to examine, firstly, the significance of inherited path-dependent arrangements in fostering conflict and crisis tendencies during interaction with emergent state action; secondly, the extent to which crisis is evident in processes of institutional change and the form that this takes; and, thirdly, the importance of ideas in producing institutional transformation. It is found that institutional conflict is evident between inherited institutions and emergent state action, and stems both from the way agents are organised by the state and from certain path dependencies, but that this does not lead to an actual material crisis. Rather, the nation-state, in partnership with senior city government actors, use ideational/discursive ‘crisis talk’ as a means by which to induce institutional change. The role of ideas has been in critical in this process as the nation-state frames problems and solutions in line with its existing policy paradigm and institutional arrangements, and with discourses further reinforcing existing material power relations.

Urban labour, voice and legitimacy:economic development and the emergence of community unionism

Community unionism has emerged in the past decade as a growing strand of industrial relations research and is influencing trade union strategies for renewal. This article seeks to further develop the concept, while exploring the potential roles for unions in communities subject to projects of urban regeneration.

Urban politics and the social practices of critique and justification:conceptual insights from French pragmatism

Recent times have witnessed a growing belief in urban spaces as 'assemblages' produced through interwoven and spatially differentiated forces that converge at particular sites. There is also continuing interest in the nature of neoliberal tendencies and the rise of post-politics and democracy in urban governance. These accounts typically lack attention towards the comprehensive conceptualization of the heterogeneous logics and mechanics of relations and negotiations between actors. This paper seeks to advance these perspectives by exploring the potential contribution of French pragmatism thinking to how social life is produced through practical dialogue between actors through critique, argumentation and justification. © The Author(s) 2012.

Effects of the current financial and economic crisis on the rural landscape as well as the agri-food sector in Europe and Central Asia

This paper reviews the expected effects of the current financial crisis and subsequent recession on the rural landscape, in particular the agri-food sector in Europe and Central Asia (ECA) on the basis of the structure of the rural economy and of different organisations and institutions. Empirical evidence suggests that the crisis has hit the ECA region the hardest. Agriculture contributes about 9% to gross domestic product (GDP) for the ECA region as a whole with 16% of the population being employed in the agricultural sector. As far as the impact of the financial crisis on the agri-food sector is concerned, there are a few interconnected issues: (1) reduction in income elastic food demand and commodity price decline, (2) loss of employment and earnings of rural people working in urban centres, implying also costly labour reallocation, (3) rising rural poverty originating mainly from lack of opportunities in the non-farm sector and a sizable decline of international remittances, (4) tightening of agricultural credit markets, and the (5) collapse of sectoral government support programs and social safety-net measures in many countries. The paper reveals how the crisis hit farming and broader agri-business differently in general and in the ECA sub-regions.

Extending the Theory of Planned Behavior in the exercise domain: A study of community college students in an urban multicultural setting

The purpose of this study was to assess the intention to exercise among ethnically and racially diverse community college students using the Theory of Planned Behavior (TPB). In addition to identifying the variables associated with motivation or intention of college students to engage in physical activity, this study tested the model of the Theory of Planned Behavior, asking: Does the TPB model explain intention to exercise among a racially/ethnically diverse group of college students? ^ The relevant variables were the TPB constructs (behavioral beliefs, normative beliefs, and control beliefs), which combined to form a measure of intention to exercise. Structural Equation Modeling was used to test the predictive power of the TPB constructs for predicting intention to exercise. Following procedures described by Ajzen (2002), the researcher developed a questionnaire encompassing the external variables of student demographics (age, gender, work status, student status, socio-economic status, access to exercise facilities, and past behavior), major constructs of the TPB, and two questions from the Godin Leisure Time Questionnaire (GLTQ; Godin & Shephard, 1985). Participants were students (N = 255) who enrolled in an on-campus wellness course at an urban community college. ^ The demographic profile of the sample revealed a racially/ethnically diverse study population. The original model that was used to reflect the TPB as developed by Ajzen was not supported by the data analyzed using SEM; however, a revised model that the researcher thought was theoretically a more accurate reflection of the causal relations between the TPB constructs was supported. The GLTQ questions were problematic for some students; those data could not be used in the modeling efforts. The GLTQ measure, however, revealed a significant correlation with intention to exercise (r = .27, p = .001). Post-hoc comparisons revealed significant differences in normative beliefs and attitude toward exercising behavior between Black students and Hispanic students. Compared to Black students, Hispanic students were more likely to (a) perceive “friends” as approving of them being physically active and (b) rate being physically active for 30 minutes per day as “beneficial”. No statistically significant difference was found among groups on overall intention to exercise. ^

The electoral geography of the Slovak Republic: A comparison of the 1994, 1998, and 2002 parliamentary elections

In what can rightly be said to be one of the most dramatic geopolitical shifts in modern times, the collapse of communist regimes in Central Europe and the former Soviet Union brought about dramatic changes in the entire region. As a consequence, wide ranging political, economic, and social transformations have occurred in almost all of these countries since 1989. The Slovak Republic, as a newly democratic country, went through the establishment of the electoral and party systems that are the central mechanisms to the formation of almost all modern democratic governments. The primary research purpose of this dissertation was to describe and explain regional variations in party support during Slovakia’s ten years of democratic transformation. A secondary purpose was to relate these spatial variations to the evolution of political parties in the post-independence period in light of the literature on transitional electoral systems. Research questions were analyzed using both aggregate and survey data. Specifically, the study utilized electoral data from 1994, 1998, and 2002 Slovak parliamentary elections and socio-economic data of the population within Slovak regions which were eventually correlated with the voting results by party in the 79 Slovak districts. The results of this study demonstrate that there is a tendency among voters in certain regions to provide continuous support to the same political parties/movements over time. In addition, the socio-economic characteristics of the Slovak population (gender, age, education, religion, nationality, unemployment, work force distribution, wages, urban-rural variable, and population density) in different regions tend to influence voting preferences in the parliamentary elections. Finally, there is an evident correlation between party preference and the party’s position on integration into European Union, as measured by perceived attitudes regarding the benefits of EU membership.

Re-imagining Yerevan in the post-Soviet era: Urban symbolism and narratives of the nation in the landscape of Armenia's capital

The urban landscape of Yerevan has experienced tremendous changes since the collapse of the Soviet Union and Armenia’s independence in 1991. Domestic and foreign investments have poured into Yerevan’s building sector, converting many downtown neighborhoods into sleek modern districts that now cater to foreign investors, tourists, and the newly rich Armenian nationals. Large portions of the city’s green parks and other public spaces have been commercialized for private and exclusive use, creating zones that are accessible only to the affluent. In this dissertation I explore the rapidly transforming landscape of Yerevan and its connections to the development of contemporary Armenian national identity. This research was guided by principles of ethnographic inquiry, and I employed diverse methods, including document and archival research, structured and semi-structured interviews and content analysis of news media. I also used geographic information systems (GIS) and satellite images to represent and visualize the stark transformations of spaces in Yerevan. Informed by and contributing to three literatures—on the relationship between landscape and identity formation, on the construction of national identity, and on Soviet and post-Soviet cities—this dissertation investigates how messages about contemporary Armenian national identity are being expressed via the transforming landscape of Armenia’s national capital. In it I describe the ways in which abrupt transformations have resulted in the physical and symbolic eviction of residents, introducing fierce public debates about belonging and exclusion within the changing urban context. I demonstrate that the new additions to Yerevan’s landscape and the symbolic messages that they carry are hotly contested by many long-time residents, who struggle for inclusion of their opinions and interests in the process of re-imagining their national capital. This dissertation illustrates many of the trends that are apparent in post-Soviet and post-Socialist space, while at the same time exposing some unique characteristics of the Armenian case.

Adapting Mpowerment to a Rural Area

As HIV/AIDS continues to disproportionately impact men who have sex with men (MSM) (CDC, 2010a), effective and timely prevention strategies for this population must be developed. Specifically, evidence-based interventions that can be easily adapted and have proven effectiveness are needed. Hence, the purpose of the current study was to assess the impact of the Mpowerment Project (Hayes, Rebchook, & Kegeles, 2003), a community level HIV prevention program originally designed for young urban gay men, when adapted for rural gay men. The Mpowerment Project is recognized as evidence- based intervention by the CDC (CDC, 2009b). The current study is an extension of this research, assessing Mpowerment model fidelity and the behavioral and attitudinal changes that occurred among participants. Data were collected from participants in a rural area of southeast Idaho from 2002-2004. Data were collected prior to M-Group participation and at a three months follow-up. The 66 individuals completing the M-Group pre and posttest assessment also attended a minimum of three study events and a maximum of 226 events. Results revealed no significant changes in attitudinal variables and all but one behavioral variable among Rural Mpowerment (R-MP) participants. The one significant behavior change was an increase in reported safer sex discussion among friends, indicating a possible change in the social norm regarding safer sex. Results also indicate that program fidelity was maintained and the Mpowerment Project is adaptable to rural areas. However, there was no indication of attitudinal changes in participants of this study. There were no changes in behavioral variables aside from discussion about safer sex with friends increasing. The lack of evidence-based interventions for rural gay men highlights the need for further research on the community impact of the Mpowerment Project on rural participants.

Adapting Mpowerment to a rural area

As HIV/AIDS continues to disproportionately impact men who have sex with men (MSM) (CDC, 2010a), effective and timely prevention strategies for this population must be developed. Specifically, evidence-based interventions that can be easily adapted and have proven effectiveness are needed. Hence, the purpose of the current study was to assess the impact of the Mpowerment Project (Hayes, Rebchook, & Kegeles, 2003), a community level HIV prevention program originally designed for young urban gay men, when adapted for rural gay men. The Mpowerment Project is recognized as evidence- based intervention by the CDC (CDC, 2009b). The current study is an extension of this research, assessing Mpowerment model fidelity and the behavioral and attitudinal changes that occurred among participants. Data were collected from participants in a rural area of southeast Idaho from 2002-2004. Data were collected prior to M-Group participation and at a three months follow-up. The 66 individuals completing the M-Group pre and posttest assessment also attended a minimum of three study events and a maximum of 226 events. Results revealed no significant changes in attitudinal variables and all but one behavioral variable among Rural Mpowerment (R-MP) participants. The one significant behavior change was an increase in reported safer sex discussion among friends, indicating a possible change in the social norm regarding safer sex. Results also indicate that program fidelity was maintained and the Mpowerment Project is adaptable to rural areas. However, there was no indication of attitudinal changes in participants of this study. There were no changes in behavioral variables aside from discussion about safer sex with friends increasing. The lack of evidence-based interventions for rural gay men highlights the need for further research on the community impact of the Mpowerment Project on rural participants.