The private problem with public service: Rural teachers in educational markets

Staffing rural and remote schools is an important policy issue for the public good. This paper examines the private issues it also poses for teachers with families working in these communities, as they seek to reconcile careers with educational choices for children. The paper first considers historical responses to staffing rural and remote schools in Australia, and the emergence of neoliberal policy encouraging marketisation of the education sector. We report on interviews about considerations motivating household mobility with 11 teachers across regional, rural and remote communities in Queensland. Like other middle-class parents, these teachers prioritised their children’s educational opportunities over career opportunities. The analysis demonstrates how teachers in rural and remote communities constitute a special group of educational consumers with insider knowledge and unique dilemmas around school choice. Their heightened anxieties around school choice under neoliberal policy are shown to contribute to the public issue of staffing rural and remote schools.

Cultural safety, diversity and the servicer user and carer movement in mental health research

This study will be of interest to anyone concerned with a critical appraisal of mental health service users’ and carers’ participation in research collaboration and with the potential of the postcolonial paradigm of cultural safety to contribute to the service user research (SUR) movement. The history and nature of the mental health field and its relationship to colonial processes provokes a consideration of whether cultural safety could focus attention on diversity, power imbalance, cultural dominance and structural inequality, identified as barriers and tensions in SUR. We consider these issues in the context of state-driven approaches towards SUR in planning and evaluation and the concurrent rise of the SUR movement in the UK and Australia, societies with an intimate involvement in processes of colonisation. We consider the principles and motivations underlying cultural safety and SUR in the context of the policy agenda informing SUR. We conclude that while both cultural safety and SUR are underpinned by social constructionism constituting similarities in principles and intent, cultural safety has additional dimensions. Hence, we call on researchers to use the explicitly political and self-reflective process of cultural safety to think about and address issues of diversity, power and social justice in research collaboration.

Investigation of pedestrian crashes on two-way two-lane rural roads in Ethiopia

Understanding pedestrian crash causes and contributing factors in developing countries is critically important as they account for about 55% of all traffic crashes. Not surprisingly, considerable attention in the literature has been paid to road traffic crash prediction models and methodologies in developing countries of late. Despite this interest, there are significant challenges confronting safety managers in developing countries. For example, in spite of the prominence of pedestrian crashes occurring on two-way two-lane rural roads, it has proven difficult to develop pedestrian crash prediction models due to a lack of both traffic and pedestrian exposure data. This general lack of available data has further hampered identification of pedestrian crash causes and subsequent estimation of pedestrian safety performance functions. The challenges are similar across developing nations, where little is known about the relationship between pedestrian crashes, traffic flow, and road environment variables on rural two-way roads, and where unique predictor variables may be needed to capture the unique crash risk circumstances. This paper describes pedestrian crash safety performance functions for two-way two-lane rural roads in Ethiopia as a function of traffic flow, pedestrian flows, and road geometry characteristics. In particular, random parameter negative binomial model was used to investigate pedestrian crashes. The models and their interpretations make important contributions to road crash analysis and prevention in developing countries. They also assist in the identification of the contributing factors to pedestrian crashes, with the intent to identify potential design and operational improvements.

Religion, spirituality, and mental health and social behaviour in young adulthood: A longitudinal study

Background The concept spirituality appears to be gaining increasing attention for its potential relationship to mental health, despite there being an absence of consensus on what spirituality is or whether it can be distinguished from religion (or religiousness) in operational terms. Spirituality is a term that is embraced within secular and non-secular contexts alike. As a consequence, spirituality as a concept encompasses forms of religiosity that are embedded in traditional religion and those that have little or no connection to traditional religious teachings. The emergence of religious/spiritual beliefs that depart from traditional religious thought represents one key feature of widespread religious change in contemporary societies. Non-traditional religious/spiritual beliefs need to be viewed within this context and thus be differentiated from traditional religious/spiritual beliefs when investigating connections between religion, spirituality, and mental health. Aims The current study seeks to compare the mental health of those whose beliefs are rooted in religious tradition with those whose beliefs deviate from traditional religious thought. The two main objectives of this study are: (1) to determine the extent to which religious background predicts endorsement of traditional and non-traditional religious/spiritual beliefs and church attendance in young adulthood, and; (2) to determine whether differential relationships exist between current religiosity, religious background, and mental health in young adulthood, and whether any observed differences are attributable to other characteristics of respondents like sociodemographic factors and health-risk behaviours. Methods Data were derived from the Mater-University of Queensland Study of Pregnancy, a longitudinal, prospective study of maternal and child health from the prenatal period to 21 years post-delivery. Religiosity was assessed among the study children in young adulthood from three items measured at the time of the 21-year follow-up. Religious background was assessed from information provided by the study mothers in earlier phases of the study. Young adult responses to items included in the Young Adult Self Report (Achenbach, 1997) were used to assess cases of anxiety/depression and externalising behaviour, and delusional ideation was assessed from their responses to the 21-item Peters et al. Delusions Inventory (PDI) (Peters & Garety, 1996). Results Belief in a spiritual or higher power other than God was found to be positively related to anxiety/depression, disturbed ideation, suspiciousness and paranormal ideation, high total PDI scores, as well as antisocial behaviour in young adulthood, regardless of gender. These associations persisted after adjustment for potential confounders. By contrast, young adults who maintain a traditional belief in God appear to be no different to those who reject this belief in regard to anxiety/depression. Belief in God was found to have no association with antisocial behaviour for males, but was observed to have a weak negative relationship with antisocial behaviour for females. This association failed to reach statistical significance however, after adjustment for other religious/spiritual and social characteristics. No associations were found between young adult belief in God and disturbed, suspicious or paranormal ideation, although a positive relationship was identified for high total PDI scores. Weekly church attendance was observed to reduce the likelihood of antisocial behaviour in young adulthood among males, but not females. Religious ideation was found to more prevalent among young adults who attend church on either a weekly or infrequent basis. No long-term effects on anxiety/depression or antisocial behaviour were evident from maternal belief in God, church attendance or religious affiliation in the young adults’ early lives. However, maternal church attendance predicted religious ideation in young adulthood. Offspring of mothers affiliated with a Pentecostal church in the prenatal period appear to have a high rate of religious ideation and high total PDI scores. Paranormal ideation in young adulthood appears to have no association with maternal religiosity in a young adult’s early life. Conclusion The findings from this study suggest that young adults who endorse non-traditional religious/spiritual beliefs are at greater risk for poorer mental health and aberrant social behaviour than those who reject these beliefs. These results suggest that a non-traditional religious/spiritual belief system involves more than mere rejection of traditional religious doctrine. This system of belief may be a marker for those who question the legitimacy of established societal norms and values, and whose thoughts, attitudes and actions reflect this position. This possibility has implications for mental health and wellbeing at both an individual and a societal level and warrants further research attention.

Specificity and context in post-exercise recovery: It is not a one-size-fits-all approach

The concept of specificity of exercise prescription and training is a longstanding and widely accepted foundation of the exercise sciences. Simply, the principle holds that training adaptations are achieved relative to the stimulus applied. That is, the manipulation of training variables (e.g. intensity or loading, mode, volume and frequency) directly influences the acute training stimulus, and so the long-term adaptive response (Young et al., 2001; Bird et al., 2005). Translating this concept to practice then recommends that exercise be prescribed specific to the desired outcomes, and the more closely this is achieved, the greater the performance gain is likely to be. However, the cardiovascular and metabolic adaptations traditionally associated with long, slow distance training types, similarly achieved using high-intensity training methods (for a review see Gibala et al., 2012), highlights understanding of underlying physiology as paramount for effective training program design. Various other factors including illness, sleep and psychology also impact on the training stimulus (Halson, 2014) and must be managed collectively with appropriate post-exercise recovery to continue performance improvements and reduce overtraining and injury risks (Kenttä and Hassmén, 1998).

The transition to palliative care: A critical exploration in the context of metastatic melanoma

This research explored the transition to palliative care process through critical analysis of the experiences of patients diagnosed with metastatic melanoma, family carers and health professionals. The outcomes depict a complex intersection between acute care services and palliative care where the discipline of palliative care struggled to position itself within a highly specialised health system. The findings indicate uncertainty around scopes of practice with ambiguity and tension around the transition to palliative care. The research thus argues for stronger and more coherent partnerships and a critical and interdisciplinary conversation about the positioning of palliative care in the acute care sector.

Seasonal variations of outdoor air pollution and factors driving them in the school environment in rural Bhutan

A quantitative understanding of outdoor air quality in school environments is crucial given that air pollution levels inside classrooms are significantly influenced by outdoor pollution sources. To date, only a handful of studies have been conducted on this important topic in developing countries. The aim of this study was to quantify pollutant levels in the outdoor environment of a school in Bhutan and assess the factors driving them. Measurements were conducted for 16 weeks, spanning the wet and dry seasons, in a rural school in Bhutan. PM10, PM2.5, particle number (PN) and CO were measured daily using real-time instruments, while weekly samples for volatile organic compounds (VOCs), carbonyls and NO2 were collected using a passive sampling method. Overall mean PM10 and PM2.5 concentrations (µg/m3) were 27 and 13 for the wet, and 36 and 29 for the dry season, respectively. Only wet season data were available for PN concentrations, with a mean of 2.56 × 103 particles/cm3. Mean CO concentrations were below the detection limit of the instrumentation for the entire measurement period. Only low levels of eight VOCs were detected in both the wet and dry seasons, which presented different seasonal patterns in terms of the concentration of different compounds. The notable carbonyls were formaldehyde and hexaldehyde, with mean concentrations (µg/m3) of 2.37 and 2.41 for the wet, and 6.22 and 0.34 for the dry season, respectively. Mean NO2 cocentration for the dry season was 1.7 µg/m3, while it was below the detection limit of the instrumentation for the wet season. The pollutant concentrations were associated with a number of factors, such as cleaning and combustion activities in and around the school. A comparison with other school studies showed comparable results with a few of the studies, but in general, we found lower pollutant concentrations in the present study.

Moving from theory to praxis on the fly: Introducing a salutogenic method to expedite mental health care provision in disaster situations

Not a lot is known about most mental illness. Its triggers can rarely be established and nor can its aetiological dynamics, so it is hardly surprising that the accepted treatments for most mental illnesses are really strategies to manage the most overt symptoms. But with such a dearth of knowledge, how can worthy decisions be made about psychiatric interventions, especially given time and budgetary restrictions? This paper introduces a method, extrapolated from Salutogenics; the psycho-social theory of health introduced by Antonovsky in 1987. This method takes a normative stance (that psychiatric health care is for the betterment of psychiatric patients), and applies it to any context where there is a dearth of workable knowledge. In lieu of guiding evidence, the method identifies reasonable alternatives on the fly, enabling rational decisions to be made quickly with limited resources.

Parkinson's disease, nutrition, and surgery in context of critical care

Parkinson’s disease is a common neurodegenerative disorder with a higher risk of hospitalization than the general population. Therefore, there is a high likelihood of encountering a person with Parkinson’s disease in acute or critical care. Most people with Parkinson’s disease are over the age of 60 years and are likely to have other concurrent medical conditions. Parkinson’s disease is more likely to be the secondary diagnosis during hospital admission. The primary diagnosis may be due to other medical conditions or as a result of complications from Parkinson’s disease symptoms. Symptoms include motor symptoms, such as slowness of movement and tremor, and non-motor symptoms, such as depression, dysphagia, and constipation. There is a large degree of variation in the presence and degree of symptoms as well as in the rate of progression. There is a range of medications that can be used to manage the motor or non-motor symptoms, and side effects can occur. Improper administration of medications can result in deterioration of the patient’s condition and potentially a life-threatening condition called neuroleptic malignant-like syndrome. Nutrients and delayed gastric emptying may also interfere with intestinal absorption of levodopa, the primary medication used for motor symptom management. Rates of protein-energy malnutrition can be up to 15 % in people with Parkinson’s disease in the community, and this is likely to be higher in the acute or critical care setting. Nutrition-related care in this setting should utilize the Nutrition Care Process and take into account each individual’s Parkinson’s disease motor and non-motor symptoms, the severity of disease, limitations due to the disease, medical management regimen, and nutritional status when planning nutrition interventions. Special considerations may need to be taken into account in relation to meal and medication times and the administration of enteral feeding. Nutrition screening, assessment, and monitoring should occur during admission to minimize the effects of Parkinson's disease symptoms and to optimise nutrition-related outcomes.

The organisational context of nursing care in stroke units: A case study approach

Background Internationally the stroke unit is recognised as the evidence-based model for patient management, although clarity about the effective components of stroke units is lacking. Whilst skilled nursing care has been proposed as one component, the theoretical and empirical basis for stroke nursing is limited. We attempted to explore the organisational context of stroke unit nursing, to determine those features that staff perceived to be important in facilitating high quality care. Design A case study approach was used, that included interviews with nurses and members of the multidisciplinary teams in two Canadian acute stroke units. A total of 20 interviews were completed, transcribed and analysed thematically using the Framework Approach. Trustworthiness was established through the review of themes and their interpretation by members of the stroke units. Findings Nine themes that comprised an organisational context that supported the delivery of high quality nursing care in acute stroke units were identified, and provide a framework for organisational development. The study highlighted the importance of an overarching service model to guide the organisation of care and the development of specialist and advanced nursing roles. Whilst multidisciplinary working appears to be a key component of stroke unit nursing, various organisational challenges to its successful implementation were highlighted. In particular the consequence of differences in the therapeutic approach of nurses and therapy staff needs to be explored in greater depth. Successful teamwork appears to depend on opportunities for the development of relationships between team members as much as the use of formal communication systems and structures. A co-ordinated approach to education and training, clinical leadership, a commitment to research, and opportunities for role and practice development also appear to be key organisational features of stroke unit nursing. Recommendations for the development of stroke nursing leadership and future research into teamwork in stroke settings are made.

A perfusion fMRI investigation of thematic and categorical context effects in the spoken production of object names

The context in which objects are presented influences the speed at which they are named. We employed the blocked cyclic naming paradigm and perfusion functional magnetic resonance imaging (fMRI) to investigate the mechanisms responsible for interference effects reported for thematicallyand categorically related compared to unrelated contexts. Naming objects in categorically homogeneous contexts induced a significant interference effect that accumulated from the second cycle onwards. This interference effect was associated with significant perfusion signal decreases in left middle and posterior lateral temporal cortex and the hippocampus. By contrast, thematically homogeneous contexts facilitated naming latencies significantly in the first cycle and did not differ from heterogeneous contexts thereafter, nor were they associated with any perfusion signal changes compared to heterogeneous contexts. These results are interpreted as being consistent with an account in which the interference effect both originates and has its locus at the lexical level, with an incremental learning mechanism adapting the activation levels of target lexical representations following access. We discuss the implications of these findings for accounts that assume thematic relations can be active lexical competitors or assume mandatory involvement of top-down control mechanisms in interference effects during naming.

Auditory context effects in picture naming investigated with event-related fMRI

Naming an object entails a number of processing stages, including retrieval of a target lexical concept and encoding of its phonological word form. We investigated these stages using the picture-word interference task in an fMRI experiment. Participants named target pictures in the presence of auditorily presented semantically related, phonologically related, or unrelated distractor words or in isolation. We observed BOLD signal changes in left-hemisphere regions associated with lexical-conceptual and phonological processing, including the midto-posterior lateral temporal cortex. However, these BOLD responses manifested as signal reductions for all distractor conditions relative to naming alone. Compared with unrelated words, phonologically related distractors showed further signal reductions, whereas only the pars orbitalis of the left inferior frontal cortex showed a selective reduction in response in the semantic condition. We interpret these findings as indicating that the word forms of lexical competitors are phonologically encoded and that competition during lexical selection is reduced by phonologically related distractors. Since the extended nature of auditory presentation requires a large portion of a word to be presented before its meaning is accessed, we attribute the BOLD signal reductions observed for semantically related and unrelated words to lateral inhibition mechanisms engaged after target name selection has occurred, as has been proposed in some production models.

Direct mapping of hippocampal surfaces with intrinsic shape context

We propose in this paper a new method for the mapping of hippocampal (HC) surfaces to establish correspondences between points on HC surfaces and enable localized HC shape analysis. A novel geometric feature, the intrinsic shape context, is defined to capture the global characteristics of the HC shapes. Based on this intrinsic feature, an automatic algorithm is developed to detect a set of landmark curves that are stable across population. The direct map between a source and target HC surface is then solved as the minimizer of a harmonic energy function defined on the source surface with landmark constraints. For numerical solutions, we compute the map with the approach of solving partial differential equations on implicit surfaces. The direct mapping method has the following properties: (1) it has the advantage of being automatic; (2) it is invariant to the pose of HC shapes. In our experiments, we apply the direct mapping method to study temporal changes of HC asymmetry in Alzheimer's disease (AD) using HC surfaces from 12 AD patients and 14 normal controls. Our results show that the AD group has a different trend in temporal changes of HC asymmetry than the group of normal controls. We also demonstrate the flexibility of the direct mapping method by applying it to construct spherical maps of HC surfaces. Spherical harmonics (SPHARM) analysis is then applied and it confirms our results on temporal changes of HC asymmetry in AD.

On food security and alternative food networks: Understanding and performing food security in the context of urban bias

This paper offers one explanation for the institutional basis of food insecurity in Australia, and argues that while alternative food networks and the food sovereignty movement perform a valuable function in building forms of social solidarity between urban consumers and rural producers, they currently make only a minor contribution to Australia’s food and nutrition security. The paper begins by identifying two key drivers of food security: household incomes (on the demand side) and nutrition-sensitive, ‘fair food’ agriculture (on the supply side). We focus on this second driver and argue that healthy populations require an agricultural sector that delivers dietary diversity via a fair and sustainable food system. In order to understand why nutrition-sensitive, fair food agriculture is not flourishing in Australia we introduce the development economics theory of urban bias. According to this theory, governments support capital intensive rather than labour intensive agriculture in order to deliver cheap food alongside the transfer of public revenues gained from rural agriculture to urban infrastructure, where the majority of the voting public resides. We chart the unfolding of the Urban Bias across the twentieth century and its consolidation through neo-liberal orthodoxy, and argue that agricultural policies do little to sustain, let alone revitalize, rural and regional Australia. We conclude that by observing food system dynamics through a re-spatialized lens, Urban Bias Theory is valuable in highlighting rural–urban socio-economic and political economy tensions, particularly regarding food system sustainability. It also sheds light on the cultural economy tensions for alternative food networks as they move beyond niche markets to simultaneously support urban food security and sustainable rural livelihoods.

Translating training in the NYU Caregiver Intervention in Australia: Maintaining fidelity and meeting graduate standards in an online continuing professional education setting

The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent intervention for spousal caregivers. It is aimed at maintaining well-being by increasing social support and decreasing family discord, thereby delaying or avoiding nursing home placement of the person with dementia. Training in the NYUCI in the United States has, until now, been conducted in person to trainee practitioners. The Internet-based intervention was developed simultaneously for trainees in the U.S. and Australia. In Australia, due to population geography, community healthcare workers, who provide support to older adult caregivers of people with dementia, live and work in many regional and rural areas. Therefore, it was especially important to have online training available to make it possible to realize the health and economic benefits of using an existing evidence-based intervention. This study aimed to transfer knowledge of training in, and delivery of, the NYUCI for an Australian context and consumers. This article details the considerations given to contextual differences and to learners’ skillset differences in translating the NYUCI for Australia.