Higher uptake of long-acting reversible and permanent methods of contraception by Australian women living in rural and remote areas

Objectives: To examine factors associated with the uptake of i) long-acting reversible, ii) permanent and iii) traditional contraceptive methods among Australian women. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1973–78 reported on their contraceptive use at three surveys: 2003, 2006 and 2009. The participants were 5,849 women aged 25–30 in 2003 randomly sampled from Medicare. The main outcome measure was current contraceptive method at age 28–33 years categorised as long-acting reversible methods (implant, IUD, injection), permanent (tubal ligation, vasectomy), and traditional methods (oral contraceptive pills, condoms, withdrawal, safe period). Results: Compared to women living in major cities, women in inner regional areas were more likely to use long-acting (OR=1.26, 95%CI 1.03–1.55) or permanent methods (OR=1.43, 95%CI 1.17–1.76). Women living in outer regional/remote areas were more likely than women living in cities to use long-acting (OR=1.65, 95%CI 1.31–2.08) or permanent methods (OR=1.69, 95%CI 1.43–2.14). Conclusions: Location of residence is an important factor in women's choices about long-acting and permanent contraception in addition to the number and age of their children. Implications: Further research is needed to understand the role of geographical location in women's access to contraceptive options in Australia.

“Scary” heterosexualities in a rural Australian mining town

This paper draws upon Hubbard's (1999, p. 57) term ‘scary heterosexualities,’ that is non-normative heterosexuality, in the context of the rural drawing on data from fieldwork in the remote Western Australian mining town of Kalgoorlie. Our focus is ‘the skimpie’ – a female barmaid who serves in her underwear and who, in both historical and contemporary times, is strongly associated with rural mining communities. Interviews with skimpies and local residents as well as participant observation reveal how potential fears and anxieties about skimpies are managed. We identify the discursive and spatial processes by which skimpie work is contained in Kalgoorlie so that the potential scariness ‘the skimpie’ represents to the rural is muted and buttressed in terms of a more conventional and less threatening rural heterosexuality.

Doing cultural work : local postcard production and place identity in a rural shire

Studies of place construction in the rural studies literature have largely privileged the role of professionals over that of local lay actors. This paper contributes to redressing this imbalance through a critical case-study of lay postcard production in a rural shire. Drawing on original, qualitative research conducted in the Shire of Ravensthorpe, Western Australia, including in-depth interviews with key participants, the analysis focuses on this lay production—undertaken in the main by women—as cultural work. By emphasising the work of making the postcards along with the cultural work these postcards achieve, this examination foregrounds intersections of material and imagined ruralities. In the process, this study highlights the complexity and importance of this lay contribution to place identity, particularly as positioned within what may be considered rural cultural work.

Turning points in narratives of research design : research innovation stimulating unique responses to existing challenges for beginning rural teachers

This paper explores methodological turning points in researching narratives of early career resilience mediated by the complexities of remote teaching. Innovative, flexible and discursive research design facilitated exploration of emerging narratives using digital technologies. Data were regularly interrogated with participant-researchers to reveal the undercurrents of imbued meaning. Dialogue with participant-researchers enhanced interpretations of data plots and text-based explanations of narrative turning points, providing valuable insights throughout analysis. Reflections on the affordances and tensions in this process illustrate the significance of innovation but also the complexities associated with online collaboration. Consequently, empowering the participant-researchers throughout the life of the research was critical in understanding their narratives of teaching.

Secure and safe water supplies in remote Australian and rural Sri Lankan regions : common issues and emerging responses

Most urban dwelling Australians take secure and safe water supplies for granted. That is, they have an adequate quantity of water at a quality that can be used by people without harm from human and animal wastes, salinity and hardness or pollutants from agriculture and manufacturing industries. Australia wide urban and peri-urban dwellers use safe water for all domestic as well as industrial purposes. However, this is not the situation remote regions in Australia where availability and poor quality water can be a development constraint. Nor is it the case in Sri Lanka where people in rural regions are struggling to obtain a secure supply of water, irrespective of it being safe because of the impact of faecal and other contaminants. The purposes of this paper are to overview: the population and environmental health challenges arising from the lack of safe water in rural and remote communities; response pathways to address water quality issues; and the status of and need for integrated catchment management (ICM) in selected remote regions of Australia and vulnerable and lagging rural regions in Sri Lanka. Conclusions are drawn that focus on the opportunity for inter-regional collaborations between Australia and Sri Lanka for the delivery of safe water through ICM.

Tracking of physical activity, physical inactivity, and health-related physical fitness in rural youth

This study examined the tracking of selected measures of physical activity, inactivity, and fitness in a cohort of rural youth. Students (N = 181, 54.7% female, 63.5% African American) completed test batteries during their fifth-(age = 10.7 +/- 0.7 years), sixth-, and seventh-grade years. The Previous Day Physical Activity Recall (PDPAR) was used to assess 30-min blocks of vigorous physical activity (VPA), moderate-to-vigorous physical activity (MVPA), TV watching and other sedentary activities, and estimated energy expenditure (EE). Fitness measures included the PWC 170 cycle ergometer test, strength tests, triceps skinfold thickness, and BMI. Intraclass correlation coefficients (ICCs) for VPA, MVPA, and after-school EE ranged from 0.63 to 0.78. ICCs ranged from 0.49 to 0.71 for measures of inactivity and from 0.78 to 0.82 for the fitness measures. These results indicate that measures of physical activity, inactivity, and physical fitness tend to track during the transition from elementary to middle school.

The rurality of sex : community resistance and objection to prostitution in rural and regional areas throughout Queensland

Queensland legislation currently defines two legally recognised forms of prostitution: sex work conducted in a licensed brothel; or, sex work conducted privately by a sole operator.Despite prostitution’s legality in these contexts, it continues to be heavily controlled and restricted by authorities, while also being rejected by surrounding communities. Such resistance towards prostitution is demonstrated in Queensland where over 200 towns with populations of less than 25,000 have been successful in applying for exemption from the development of licensed brothels in those jurisdictions (Prostitution Licensing Authority 2012). Queensland’s legislative acknowledgement of prostitution as a legal act, while simultaneously allowing small communities to reject such activity, seems somewhat contradictory. This paper will provide a theoretical examination of common community objections to prostitution in modern society, determining whether such attitudes are applicable to communities in rural and regional Queensland towns. Additionally, this paper will incorporate an analysis of rural and urban areas via the ‘gemeinschaft‐gesellschaft’ dichotomy to understand the potential justification for opposing areas being subject to differential treatment under the law.

A prospective study of the determinants of physical activity in rural fifth-grade children

Background Understanding the factors that influence physical activity behavior is important in the design of intervention programs targeted at youth. Methods A prospective study design was used to identify the predictors of vigorous physical activity (VPA) (greater than or equal to 6 METs) and moderate and vigorous physical activity (MVPA) (greater than or equal to 3 METs) among 202 rural, predominantly African-American children. Selected social-cognitive determinants of physical activity were assessed via questionnaire in the fifth grade. Participation in VPA and MVPA was assessed via the previous day physical activity recall 1 year later in the sixth grade. Results For girls, participation in community sports, self-efficacy in overcoming barriers, enjoyment of school physical education, race (white > black), and perception of mother's activity level (active vs inactive) were significant predictors of VPA. For MVPA, participation in community sports and self-efficacy in overcoming barriers were significant predictors. For boys, self-efficacy in overcoming barriers was the only significant predictor of VPA, while beliefs regarding activity outcomes and participation in community sports were significant predictors of MVPA. Conclusion Social-cognitive constructs such as physical activity self-efficacy, access to community physical activity outlets, and positive beliefs regarding physical activity outcomes are important predictors of future physical activity behavior among rural, predominantly African-American children.

Differences in physical activity between black and white girls living in rural and urban areas

This study examined the relationship of race and rural/urban setting to physical, behavioral, psychosocial, and environmental factors associated with physical activity. Subjects included 1,668 eighth-grade girls from 31 middle schools: 933 from urban settings, and 735 from rural settings. Forty-six percent of urban girls and 59% of rural girls were Black. One-way and two-way ANOVAs with school as a covariate were used to analyze the data. Results indicated that most differences were associated with race rather than setting. Black girls were less active than White girls, reporting significantly fewer 30-minute blocks of both vigorous and moderate-to-vigorous physical activity. Black girls also spent more time watching television, and had higher BMIs and greater prevalence of overweight than White girls. However, enjoyment of physical education and family involvement in physical activity were greater among Black girls titan White girls. Rural White girls and urban Black girls had more favorable attitudes toward physical activity. Access to sports equipment, perceived safety of neighborhood, and physical activity self-efficacy were higher in White girls than Black girls.

Gender differences in physical activity and determinants of physical activity in rural fifth grade children

This study determined if gender differences in physical activity could be accounted for by differences in selected social-cognitive determinants of activity behavior. Some 334 fifth grade, predominantly African-American students provided information regarding after-school physical activity and the hypothesized determinants of activity behavior. Boys reported significantly greater participation in vigorous (greater than or equal to 6 METs) and in moderate to vigorous (greater than or equal to 4 METs). Relative to girls, boys demonstrated higher levels of physical fitness, greater self-efficacy in overcoming barriers to physical activity, greater amounts of television watching, and higher levels of participation in community sports and physical activity organizations. When mean physical activity scores for girls and boys were adjusted for the effects of these determinant variables, the significant gender difference in physical activity remained. However, adjustment for self-efficacy in overcoming barriers and community sports reduced the gender gap by 5% and 7%, respectively. In contrast, adjustment for television watching increased the gender gap by about 8%. Results indicated perceived confidence in overcoming barriers to physical activity and participation in community physical activity programs are factors related to the gender difference in physical activity.

Correlates of physical activity behavior in rural youth

The purpose of this study was to identify correlates of physical activity behavior in a sample of rural, predominantly African American youth. Three hundred sixty-one fifth-grade students from two rural counties in South Carolina (69% African American, median age = II years) completed a questionnaire designed to measure beliefs and social influences regarding physical activity, physical activity self-efficacy, perceived physical activity habits of family members and friends, and access to exercise and fitness equipment at home. After school physical activity and television watching were assessed using the Previous Day Physical Activity Recall (PDPAR). Students were classified as physically active according to a moderate physical activity standard: two or more 30-min blocks at an intensity of 3 METs (metabolic equivalents) or greater, and a vigorous physical activity standard: one or more 30-min blocks at an intensity of 6 METs or greater According to the moderate physical activity standard, 34.9% of students were classified as low-active. Multivariate analysis revealed age, gender television watching, and exercise equipment at home to be significant correlates of low activity status. According to the vigorous physical activity standard, 32.1 % of the students were classified as low-active. Multivariate analysis revealed age, gender television watching, and self-efficacy with respect to seeking support for physical activity to be significant correlates of low activity status. In summary, gender and the amount of television watching were found to be the most important correlates of physical activity in rural, predominantly African American youth.

Configurations of Gender, Class and Rurality in Resource Affected Rural Australia

Historically, class has been a key concern in studies of resource affected communities (e.g., Williamson 1982, Warwick and Littlejohn 1992). While work continues, particularly in Britain, today it reflects the rationalization of the British mining sector, and thus focuses largely on mining heritage (e.g., Strangleman et al. 1999, Dicks 2008). In contrast, this chapter examines class relations as manifest in a contemporary setting in rural Australia. This site, the Ravensthorpe Shire in the south west of Western Australia, relied largely on agriculture until 2004 when BHP Billiton commenced construction of a nickel mine in the area. This affected the entire Shire as well as the two rural communities of Ravensthorpe and Hopetoun. The mine, which was officially opened in June 2008, is one of a large number of new mineral and energy developments being established in non metropolitan areas of the country as high international demand for resources fuels significant growth in the sector. In a single six month period in 2009, for example, 15 major minerals and energy projects were completed across the nation and a further 74 projects were at advanced stages (Australian Bureau of Agricultural Economics 2009). A number of these were, as was the case in Ravensthorpe, in what had been traditionally agricultural communities.

A disaggregate discrete choice model of transportation demand by elderly and disabled people in rural Virginia

This paper uses a correlated multinomial logit model and a Poisson regression model to measure the factors affecting demand for different types of transportation by elderly and disabled people in rural Virginia. The major results are: (a) A paratransit system providing door-to-door service is highly valued by transportation-handicapped people; (b) Taxis are probably a potential but inferior alternative even when subsidized; (c) Buses are a poor alternative, especially in rural areas where distances to bus stops may be long; (d) Making buses handicap-accessible would have a statistically significant but small effect on mode choice; (e) Demand is price inelastic; and (f) The total number of trips taken is insensitive to mode availability and characteristics. These results suggest that transportation-handicapped people take a limited number of trips. Those they do take are in some sense necessary (given the low elasticity with respect to mode price or availability). People will substitute away from relying upon others when appropriate transportation is available, at least to some degree. But such transportation needs to be flexible enough to meet the needs of the people involved.

Feasibility of using technology to disseminate evidence to rural nurses and improve patient outcomes

Background: Rural African American women receive less frequent mammography screening and die of breast cancer at a higher rate than is seen in the general population. To overcome this disparity, it is necessary to assist rural providers in their efforts to influence women to obtain screening. Method: This study examined the feasibility of using distance education to disseminate knowledge about timely and appropriate mammography screening to rural nurses, using patient outcome data to evaluate the effectiveness of this intervention. Results: Overall, there was a decline in referrals and mammography screening, but the intervention group centers showed a smaller decline after the educational intervention than did the control group. Conclusion: The findings show the effect of dissemination of information and the feasibility of using patient outcome data for educational evaluation. Neighboring academic health centers and nursing schools should include in their mission the provision of educational programs for relatively isolated rural nurses.