Background: Psychosocial responses to infectious disease outbreaks have the potential to inflict acute and longstanding mental health consequences. Early research across the globe has found wide ranging psychological responses to the current COVID-19 pandemic. Understanding how different coping styles can be effective in mitigating mental ill health would enable better tailored psychological support. Aims: The aim of this study was to gain an understanding of psychosocial responses to the COVID-19 pandemic, including depression, anxiety and distress, as well as effective coping styles in an Australian sample. Method: A sample of 1,495 adults, residing in Australia between April 3rd and May 3rd 2020, completed an online survey which measured psychological distress (Impact of Events Scale-Revised), depression, anxiety, stress (DASS-21), as well as coping strategies (Brief COPE). Results: 47% of the respondents were experiencing some degree of psychological distress. Females experienced higher levels of depression, anxiety and stress than males. Coping strategies associated with better mental health were positive reframing, acceptance and humour. Conversely, self-blame, venting, behavioural disengagement and self-distraction were associated with poorer mental health. Conclusion: Rates of psychological symptoms amongst the Australian population are similar to those reported in other countries. Findings add to the growing literature demonstrating a gender disparity in the mental health impacts of COVID-19. Positive emotion focused coping strategies may be effective for reducing psychological symptoms. Understanding psychosocial responses including beneficial coping strategies are crucial to manage the current COVID-19 situation optimally, as well as to develop mental health response plans for future pandemics.

Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention.

IntroductionHealth workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions.MethodsResponses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software.ResultsThe core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions.ConclusionsThe study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building.

Over the decades, the Zabaleen, the traditional waste (garbage) collectors of Cairo, have created what is arguably one of the world's most efficient and sustainable resource-recovery and waste-recycling systems. Yet the continuation of this intricate relationship between community, environment and livelihood is jeopardized by the official privatization of municipal solid waste (MSW) services through contracts with technology-intensive multinational corporations which threatens the sustainability of the garbage collectors' communities by removing access to their chief economic asset, waste or garbage. The situation is exacerbated by an official policy of moving the Zabaleen and their MSW sorting, recovery, trading and recycling activities further out of the city, on the grounds that this will turn their neighbourhoods into cleaner and healthier living environments. The consumption of Cairo's sites of MSW collection and sorting open new socio-political spaces for conflict between multi-national companies and the Zabaleen's traditional system. This is further indicated in the way Cairo's waste materials have been subjected to new claims and conflict, as they are seen as a ‗commodity' by global capital entrepreneurs and multi-national corporations, and as a source of ‗livelihood' by the disadvantaged and marginalised Zabaleen population.

Objective Combined, nursing and allied health constitute most of the Australian health workforce; yet, little is known about graduate practice destinations. University Departments of Rural Health have collaborated on the Nursing and Allied Health Graduate Outcomes Tracking to investigate graduate entry into rural practice. Design Data linkage cohort study. Setting Monash University and the University of Newcastle. Participants Graduates who completed their degree in 2017 across seven disciplines. Main outcome measure(s) The outcome variable was Australian Health Practitioner Regulation Agency principal place of practice data. Explanatory variables included discipline, age, gender, location of origin, and number and duration of rural placements. Result Of 1130 graduates, 51% were nurses, 81% females, 62% under 21 years at enrolment, 23% of rural origin, 62% had at least one rural student placement, and 23% had over 40 cumulative rural placement days. At the time of their second Australian Health Practitioner Regulation Agency registration, 18% worked in a ‘Rural principal place of practice.’ Compared to urban, rural origin graduates had 4.45 times higher odds ratio of ‘Rural principal place of practice.’ For graduates who had <20 cumulative rural placement days, compared to zero the odds ratio of ‘Rural principal place of practice’ was the same (odds ratio = 1.10). For those who had 20‐40 rural placement days, the odds ratio was 1.93, and for >40 rural placement days, the odds ratio was 4.54). Conclusion Rural origin and more rural placement days positively influenced graduate rural practice destinations. Outcomes of cumulative placements days may compare to immersive placements.

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Supervision matters: it serves educational, supportive and management functions. Despite a plethora of evidence on the effectiveness of supervision, scant evidence for the impact of supervision training exists. While three previous literature reviews have begun to examine the effectiveness of supervision training, they fail to explore the extent to which supervision training works, for whom, and why. We adopted a realist approach to answer the question: to what extent do supervision training interventions work (or not), for whom and in what circumstances, and why? We conducted a team-based realist synthesis of the supervision training literature focusing on Pawson’s five stages: (1) clarifying the scope; (2) determining the search strategy; (3) study selection; (4) data extraction; and (5) data synthesis. We extracted contexts (C), mechanisms (M) and outcomes (O) and CMO configurations from 29 outputs including short (n = 19) and extended-duration (n = 10) supervision training interventions. Irrespective of duration, interventions including mixed pedagogies involving active and/or experiential learning, social learning and protected time served as mechanisms triggering multiple positive supervisor outcomes. Short-duration interventions also led to positive outcomes through mechanisms such as supervisor characteristics, whereas facilitator characteristics was a key mechanism triggering positive and negative outcomes for extended-duration interventions. Disciplinary and organisational contexts were not especially influential. While our realist synthesis builds on previous non-realist literature reviews, our findings extend previous work considerably. Our realist synthesis presents a broader array of outcomes and mechanisms than have been previously identified, and provides novel insights into the causal pathways in which short and extended-duration supervision training interventions produce their effects. Future realist evaluation should explore further any differences between short and extended-duration interventions. Educators are encouraged to prioritize mixed pedagogies, social learning and protected time to maximize the positive supervisor outcomes from training.