Compositional, Contextual, and Collective Community Factors in Mental Health and Well-Being in Australian Rural Communities.

There are disproportionately higher and inconsistently distributed rates of recorded suicides in rural areas. Patterns of rural suicide are well documented, but they remain poorly understood. Geographic variations in physical and mental health can be understood through the combination of compositional, contextual, and collective factors pertaining to particular places. The aim of this study was to explore the role of "place" contributing to suicide rates in rural communities. Seventeen mental health professionals participated in semi-structured in-depth interviews. Principles of grounded theory were used to guide the analysis. Compositional themes were demographics and perceived mental health issues; contextual themes were physical environment, employment, housing, and mental health services; and collective themes were town identity, community values, social cohesion, perceptions of safety, and attitudes to mental illness. It is proposed that connectedness may be the underlying mechanism by which compositional, contextual, and collective factors influence mental health and well-being in rural communities.

Risk to researchers in qualitative research on sensitive topics: issues and strategies.

Traditionally, risk assessments in research have been limited to examining the risks to the research participants. Although doing so is appropriate and important, there is growing recognition that undertaking research can pose risks to researchers as well. A grounded theory study involving a range of researchers who had undertaken qualitative health research on a sensitive topic was completed. Analysis of the in-depth, face-to-face unstructured individual interviews with 30 Australian public health researchers provided evidence that researchers do confront a number of physical and emotional risks when undertaking research. Training, preparation, and supervision must be taken into account so that the risk to researchers can be minimized. Researchers need to consider occupational health and safety issues in designing research projects that deal with physical and emotional risks. Recommendations for professional supervision, policy development, and minimum training standards for researchers are provided.

Blurring boundaries in qualitative health research on sensitive topics.

Qualitative health researchers immerse themselves in the settings that they are studying. This immersion involves personal interaction with their participants, with the result that the boundaries between the researcher and the group of people under study can easily become blurred. Although health researchers have been undertaking qualitative research for many years, recognition of boundary issues inherent in this type of research have received little attention. To investigate such issues, the authors conducted interviews with 30 qualitative health researchers. A grounded theory analysis of the interview transcripts revealed that researchers can identify a number of boundaries in their research, including the boundaries between researcher and friend, researcher and counselor or therapist, and professional boundaries. The authors discuss the findings and offer recommendations for qualitative health researchers involved in researching sensitive topics, including the need for researchers to consider the impacts that undertaking research might have on them.

Do university ethics committees adequately protect public health researchers?

OBJECTIVE: This paper aims to examine whether university human research ethics committees (HRECs) proactively seek to protect members of the research team as well as study subjects in their written documentation. METHODS: A content analysis of 37 Australian university HREC application forms and attachments was undertaken. Each form was allocated to one of four predetermined categories. RESULTS: Of the 37 forms, only three included an explicit request for the applicant to reflect on all possible aspects of safety of the researchers (physical, psychological and emotional). CONCLUSION: Few HRECs have taken issues of possible harm to researchers into account in their documentation. It is recommended that HRECs explicitly recognise potential risks to researchers, especially those engaged in exploration of sensitive topics, in their processes of approving human research. It is also recommended that researchers consider the possible implications of undertaking this type of research and ensure strategies are in place to minimise these risks.

The Timed Up and Go Test: unable to predict falls on the acute medical ward.

Prevention of falls amongst older people is a high priority in health care. The aim of this study was to evaluate the ability of the Timed Up and Go Test to predict those older people who will fall whilst admitted to an acute hospital. The medical records of 160 older patients who were admitted to the medical ward of a large regional hospital were accessed retrospectively. The Timed Up and Go Test, used in isolation, was unable to identify those patients who were likely to fall. However the co-morbidity of incontinence was identified as a falls risk factor (OR = 8.7, p = 0.001). The Timed Up and Go Test alone does not possess predictive validity for acutely unwell older patients. It is therefore recommended that it not be used to identify those people who may fall.