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The Socio-Economic and Physical Contributors to Food Insecurity in a Rural Community

Australia is considered a highly food-secure nation; however, this is not always the case for every individual, household, and community. This article examines the physical and financial access to food of the population of Dorset, a rural municipality in North East Tasmania (Australia); the impact that socio-economic factors have on their food security; and the coping strategies they use when food shortages occur. A mixed-methods approach was used: Quantitative data were collected through the Tasmanian Household Food Security Survey and qualitative data through nine community focus groups conducted throughout the Dorset municipality. A total of 364 respondents (response rate 63%) completed the survey. Two main themes were identified within the data: food availability and food access. Food availability considered food origin, sustainability, and food production, whereas food access considered physical access, financial access, and other access issues such as awareness, skills, cultural preferences, and social support. The data revealed the wide-ranging effects of the importation of cheaper food alternatives, which had long-term implications not only on individuals’ health but also on the economic health of the community. A number of respondents indicated they were at times unable to buy nutritious foods due to limited finances, which led some to go without food or use other strategies to feed themselves. This study highlights the inappropriateness of the continuation of individual behavior change as a policy focus, as many of the problems facing communities are beyond individual abilities. Thus, the implications for policy from this study are centered on providing further support for strategies that focus on ensuring equity and food security for all, particularly the rural inhabitants of many food-secure nations.

E‐Portfolio for enhancing graduate research supervision

Purpose – E‐Portfolio is a powerful tool for demonstrating evidence of learning and achievements in graduate research. The purpose of this paper is to examine the concept, structure and functions of e‐Portfolio in graduate research and discuss the significance of the role of e‐Portfolio in enhancing the quality of graduate research students and their learning environment.Design/methodology/approach – The discussion starts with the concept of e‐Portfolio in the context of modern digital technology and innovative educational perspectives, which emphasise critical thinking, social interaction, task‐based learning, and independent learning.Findings – It is found that e‐Portfolio greatly enhances three important aspects of research students: academic development, research profile and social networking. E‐Portfolio empowers research students to take full control of their own learning and research journey.Originality/value – The paper shows that e‐Portfolio contributes to the enhancement of educational practices...

Women's access needs in maternity care in rural Tasmania, Australia: A mixed methods study

OBJECTIVES This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural womens challenges in accessing maternity services and (iii) rural womens access needs in maternity services. METHODS A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored womens views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. FINDINGS The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural womens access needs. CONCLUSION The study suggested that womens access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families.

Women's maternity care needs and related service models in rural areas: A comprehensive systematic review of qualitative evidence

BACKGROUND Understanding the needs of rural women in maternity care and service models available to them is significant for the development of effective policies and the sustainability of rural communities. Nevertheless, no systematic review of studies addressing these needs has been conducted. OBJECTIVES To synthesise the best available evidence on the experiences of womens needs in maternity care and existing service models in rural areas. METHODS Literature search of ten electronic databases, digital theses, and reference lists of relevant studies applying inclusion/exclusion criteria was conducted. Selected papers were assessed using standardised critical appraisal instruments from JBI-QARI. Data extracted from these studies were synthesised using thematic synthesis. FINDINGS 12 studies met the inclusion criteria. There were three main themes and several sub-themes identified. A comprehensive set of the maternity care expectations of rural women was reported in this review including safety (7), continuity of care (6) and quality of care (6), and informed choices needs (4). In addition, challenges in accessing maternity services also emerged from the literature such as access (6), risk of travelling (9) and associated cost of travel (9). Four models of maternity care examined in the literature were medically led care (5), GP-led care (4), midwifery-led care (7) and home birth (6). CONCLUSION The systematic review demonstrates the importance of including well-conducted qualitative studies in informing the development of evidence-based policies to address womens maternity care needs and inform service models. Synthesising the findings from qualitative studies offers important insight for informing effective public health policy.

Technologies for Enhancing Pedagogy, Engagement and Empowerment in Education: Creating Learning-Friendly Environments

Although there is broad agreement that preparing global citizens for the digital age is a core responsibility of educators and schools, there is debate and uncertainty about how best to prepare students for this future. Technologies for Enhancing Pedagogy, Engagement and Empowerment in Education: Creating Learning-Friendly Environments explores how technology-based learning can enhance student engagement, performance, and empowerment. This book provides researchers, educators, and practitioners with insights from educational programs, classroom teaching, and theory-into-practice research; places educational technologies appropriately in their social and cultural contexts; and reflects upon challenges and problems in evaluating and implementing changes in the field. It shows how computer-enhanced education can improve teaching and learning without confusing the increase of computer facilities with the quality of education.

Trade-off between local access and safety considerations in childbirth: rural Tasmanian women's perspectives.

OBJECTIVES This study investigates: (i) Tasmanian rural womens preferences for different models of intrapartum care; (ii) their preferences for travel time to safe delivery; and (iii) factors which influence these preferences. DESIGN Mixed-methods study using a survey questionnaire and semistructured interviews was adopted. A questionnaire explored womens preferences for different models of care and preferred travel time. Interviews were conducted to validate the survey results and provide insightful information on their preferences on the models of care. Women who have had rural childbirth experiences from six Tasmanian rural communities were invited to participate in the study. RESULTS Two hundred and ten women completed the questionnaire with a response rate of 35%. Twenty-two follow-up interviews were conducted. The survey found that women preferred to give birth in a hospital setting to homebirth despite having to travel for two hours. Midwifery-led care with one hour travel time was the second preferred model of care. Women were willing to travel to access the regional hospital but within limit. Their preferences suggest that women have to trade-off between local access and safety considerations. The interviews validate the survey results. Three main themes emerged from the interview data namely (i) safety; (ii) distance from hospital; and (iii) type of delivery. Their preferences were associated with their maternal care experiences in the past. CONCLUSION In order to achieve the maternity services that are woman centred and respond to the needs and preferences of women, the service design and provision should take into account these womens preferences.

Factors influencing community nursing roles and health service provision in rural areas: a review of literature

Aims: This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Methods: Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. Results: A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Conclusion: Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role.

Social capital among migrating doctors: the "Bridge" over troubled water

PURPOSE The purpose of this paper is to examine the concept of social capital among International Medical Graduates (IMGs). It will specifically examine bridging social capital and greater intercultural communication which provides IMGs access to the wider community and plays a key role in cross-cultural adaptation and acculturation. DESIGN/METHODOLOGY/APPROACH A review of the literature. FINDINGS An Australian wide shortage of doctors has led to an increased reliance on the recruitment of IMGs. As IMGs migrate, they may encounter different meanings of illness, models of care and a number of social challenges. Nevertheless, greater cross-cultural adaptation and acculturation occurs through bridging social capital, where intercultural communication, new social networks and identity aids integration. This process produces more opportunities for economic capital growth and upward mobility than bonding social capital. PRACTICAL IMPLICATIONS Concerns regarding immigration, appropriate support and on-going examination processes have been expressed by IMGs in a number of studies and policy papers. However, there is very little insight into what contributes cross-cultural adaptation of IMGs. ORIGINALITY/VALUE As IMGs migrate to not only a new country, but also a new health system and workplace they arrive with different cultural meanings of illness and models of care. These differences may be in contrast to the dominant western medical model, but often bring positive contributions to patient care in the new environment. In addition, improving bridging social capital provides IMGs access to the wider community and has been demonstrated to play a key role in cross-cultural adaptation and ultimately acculturation.

Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers

Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.

Comprehensive picture of rural women's needs in maternity care in Tasmania, Australia

OBJECTIVE This study investigates (i) rural womens needs in maternity care in Tasmania; (ii) the current rural maternity services in Tasmania; and (iii) the gap between womens needs and the services provided. DESIGN Mixed methods study was adopted. A questionnaire explored womens views on rural maternity services from antenatal to postnatal care and also invited comments from the participants. Interviews were conducted to provide comprehensive insights into their needs in maternity care. SETTING Six rural communities in Tasmania, Australia. PARTICIPANTS Women who have had childbirth experiences in rural areas in Tasmania. RESULTS Two hundred ten women completed the questionnaire with a response rate of 35%. There were over 150 written comments from the survey. Twenty-two follow-up interviews were conducted. This paper reports the written comments from the survey and interviews. Five main themes emerged from the data, namely (i) access needs, (ii) safety needs, (iii) needs for rural birthing services, (iv) support needs and (v) needs for quality services. CONCLUSION This study has revealed a comprehensive picture of rural womens needs in maternity care throughout their pregnancy to the early postnatal period. There is a major lack of maternity services in rural areas of Tasmania. The lack of rural maternity services shifts cost and risk from the health care system to rural women and their families. Women want to have greater access to maternity services in their local community and be ensured safety for themselves and their babies. Moreover, they need more support from the health care system and they desire quality services.