Integrating Poverty and Gender into Health Programmes : a Source Book for Health Professionals : Module on Curricular Integration

Over the past two to three decades, our understanding of poverty has broadened from a narrow focus on income and consumption to a multidimensional notion of education, health, social and political 1 participation, personal security and freedom and environmental quality. Thus, it encompasses not just low income, but lack of access to services, resources and skills; vulnerability; insecurity; and voicelessness and powerlessness. Multidimensional poverty is a determinant of health risks, health seeking behaviour, health care access and health outcomes. As analysis of health outcomes becomes more refined, it is increasingly apparent that the impressive gains in health experienced over recent decades are unevenly distributed. Aggregate indicators, whether at the global, regional or national level, often tend to mask striking variations in health outcomes between men and women, rich and poor, both across and within countries...

A cross-discipline and collaborative approach to identifying the predictors of environmentally friendly and health protective behaviour

Background. As a society, our interaction with the environment is having a negative impact on human health. For example, an increase in car use for short trips, over walking or cycling, has contributed to an increase in obesity, diabetes and poor heart health and also contributes to pollution, which is associated with asthma and other respiratory diseases. In order to change the nature of that interaction, to be more positive and healthy, it is recommended that individuals adopt a range of environmentally friendly behaviours (such as walking for transport and reducing the use of plastics). Effective interventions aimed at increasing such behaviours will need to be evidence based and there is a need for the rapid communication of information from the point of research, into policy and practice. Further, a number of health disciplines, including psychology and public health, share a common mission to promote health and well-being. Therefore, the objective of this project is to take a cross-discipline and collaborative approach to reveal psychological mechanisms driving environmentally friendly behaviour. This objective is further divided into three broad aims, the first of which is to take a cross-discipline and collaborative approach to research. The second aim is to explore and identify the salient beliefs which most strongly predict environmentally friendly behaviour. The third aim is to build an augmented model to explain environmentally friendly behaviour. The thesis builds on the understanding that an interdisciplinary collaborative approach will facilitate the rapid transfer of knowledge to inform behaviour change interventions. Methods. The application of this approach involved two surveys which explored the psycho-social predictors of environmentally friendly behaviour. Following a qualitative pilot study, and in collaboration with an expert panel comprising academics, industry professionals and government representatives, a self-administered, Theory of Planned Behaviour (TPB) based, mail survey was distributed to a random sample of 3000 residents of Brisbane and Moreton Bay Region (Queensland, Australia). This survey explored specific beliefs including attitudes, norms, perceived control, intention and behaviour, as well as environmental altruism and green identity, in relation to walking for transport and switching off lights when not in use. Following analysis of the mail survey data and based on feedback from participants and key stakeholders, an internet survey was employed (N=451) to explore two additional behaviours, switching off appliances at the wall when not in use, and shopping with reusable bags. This work is presented as a series of interrelated publications which address each of the research aims. Presentation of Findings. Chapter five of this thesis consists of a published paper which addresses the first aim of the research and outlines the collaborative and multidisciplinary approach employed in the mail survey. The paper argued that forging alliances with those who are in a position to immediately utilise the findings of research has the potential to improve the quality and timely communication of research. Illustrating this timely communication, Chapter six comprises a report presented to Moreton Bay Regional Council (MBRC). This report addresses aim's one and two. The report contains a summary of participation in a range of environmentally friendly behaviours and identifies the beliefs which most strongly predicted walking for transport and switching off lights (from the mail survey). These salient beliefs were then recommended as targets for interventions and included: participants believing that they might save money; that their neighbours also switch off lights; that it would be inconvenient to walk for transport and that their closest friend also walks for transport. Chapter seven also addresses the second aim and presents a published conference paper in which the salient beliefs predicting the four specified behaviours (from both surveys) are identified and potential applications for intervention are discussed. Again, a range of TPB based beliefs, including descriptive normative beliefs, were predictive of environmentally friendly behaviour. This paper was also provided to MBRC, along with recommendations for applying the findings. For example, as descriptive normative beliefs were consistently correlated with environmentally friendly behaviour, local councils could engage in marketing and interventions (workshops, letter box drops, internet promotions) which encourage parents and friends to model, rather than simply encourage, environmentally friendly behaviour. The final two papers, presented in Chapters eight and nine, addresses the third aim of the project. These papers each present two behaviours together to inform a TPB based theoretical model with which to predict environmentally friendly behaviour. A generalised model is presented, which is found to predict the four specific behaviours under investigation. The role of demographics was explored across each of the behaviour specific models. It was found that some behaviour's differ by age, gender, income or education. In particular, adjusted models predicted more of the variance in walking for transport amongst younger participants and females. Adjusted models predicted more variance in switching off lights amongst those with a bachelor degree or higher and predicted more variance in switching off appliances amongst those on a higher income. Adjusted models predicted more variance in shopping with reusable bags for males, people 40 years or older, those on a higher income and those with a bachelor degree or higher. However, model structure and general predictability was relatively consistent overall. The models provide a general theoretical framework from which to better understand the motives and predictors of environmentally friendly behaviour. Conclusion. This research has provided an example of the benefits of a collaborative interdisciplinary approach. It has identified a number of salient beliefs which can be targeted for social marketing campaigns and educational initiatives; and these findings, along with recommendations, have been passed on to a local council to be used as part of their ongoing community engagement programs. Finally, the research has informed a practical model, as well as behaviour specific models, for predicting sustainable living behaviours. Such models can highlight important core constructs from which targeted interventions can be designed. Therefore, this research represents an important step in undertaking collaborative approaches to improving population health through human-environment interactions.

Australia’s rural youth, online storytelling and identity performance

Online storytelling spaces provide young people who live in rural and remote parts of Australia with an opportunity to develop their personal identities and connect and communicate with other young people. The Australian Broadcasting Corporation’s (ABC’s) rural and regional youth network, Heywire, is such a space (http://www.abc.net.au/heywire/). Heywire invites 16-22 year old Australians who identify as ‘rural’ or ‘regional’ to create an online profile and upload stories about their lives in the form of text, audio, video or photographs. Emerging from my PhD project, this paper describes how rural and regional youth perform their identities through creating stories for the Heywire website, addressing notions of individual and social identities as a sub-theme. Compared with their city counterparts, the youth who live in regional towns or isolated properties have fewer opportunities to socialise with other people their own age. Subsequently computer mediated technologies, particularly the internet, can enable this group of people to connect with each other and develop a sense of community. In this paper I outline how these possibilities exist within an online storytelling space. I describe a number of reasons for young people’s story-sharing on the Heywire website in order to demonstrate the potential for spaces such as this to enable isolated youth to experience a sense of connection and belonging, despite geographical dispersion and physical isolation.

Accountancy capstone : enhancing integration and professional identity

Capstone units are generally seen to have three main aims: integrating the program, reflecting on prior learning, and transitioning into the workplace. However, research indicates that most programs do not achieve outcomes in all three areas with Henscheid (2000) revealing that integration is the major goal of many capstone programs. As well, in the accounting education literature there has been little empirical evidence relating to the effectiveness of student learning as a result of implementing a capstone unit. This study reports on the development and implementation of an accountancy capstone unit at the Queensland University of Technology (QUT), which began in 2006. The main features of this capstone unit are: the use of problem-based learning (PBL); integration of the program; the development of a professional identity whereby classes are broken up into groups of a maximum of five students who take on the persona of a professional accounting firm for an entire semester; and the students, acting as professional advisors within that firm, are required to solve a series of unstructured, multi-dimensional accounting problems based on limited given facts. This process is similar to a professional advisor asking a client about the facts relating to the particular problem of the client and then solving the problem. The research was conducted over nine semesters and involved the collection of both quantitative and qualitative data from a student questionnaire. The results indicate that in terms of student perceptions, the capstone unit was very effective in enhancing integration of the program and enhancing professional identity thereby assisting student transition into the professional accounting workplace. Our approach therefore meets two of the three generally accepted aims of a capstone unit. With accounting educators striving to maximise student learning from a finite set of resources, this approach using PBL has resulted in improved learning outcomes for accounting students about to enter the workplace as professionals.

Examining gender differences in drivers' thoughts and feelings about different outcomes of speeding: Implications for future anti-speeding messages

Speeding remains a pervasive road safety problem, increasing both crash frequency and severity. Advertising countermeasures which aim to change individuals’ attitudes and behaviours are a key component in the array of countermeasures aimed at reducing this risky behaviour. Enhancing individuals’ perceptions of the personal relevance of such messages is important for increasing persuasiveness. This study examined what males and females reported as the most concerning aspects associated with (i) receiving a speeding fine, (ii) losing one’s license, and (iii) being involved in a crash. For each of these outcomes, a range of specific and appropriate aspects were assessed. For instance, in relation to receiving a fine, individuals reported the extent to which they would, for example, feel concerned about losing demerit points and paying more in insurance premiums. An online survey of 751 drivers (579 males; 16-79 years) was administered. When controlling for age, overall significant gender differences were found in relation to two of the three outcomes; receiving a fine and being in a crash. Follow-up tests of univariate effects revealed that females consistently reported being significantly more concerned than males on all aspects. Thus, for being fined, females were significantly more concerned with, for example, being caught and receiving a ticket in the mail; while, for being in a crash, specific aspects included, for example, injuring/killing oneself and seeing oneself as not a good/safe driver. The findings are discussed in terms of their implications for developing well-targeted messages aimed at discouraging drivers from speeding.

The construction of social identity in new nuclear operators : a longitudinal study

Countless studies have stressed the importance of social identity, particularly its role in various organizational outcomes, yet questions remain as to how identities initially develop, shift and change based on the configuration of multiple, pluralistic relationships grounded in an organizational setting. The interactive model of social identity formation has been proposed recently to explain the internalization of shared norms and values – critical in identity formation – has not received empirical examination. We analyzed multiple sources of data from nine nuclear professionals over three years to understand the construction of social identity in new entrants entering an organization. Informed by our data analyses, we found support for the interactive model and that age and level of experience influenced whether they undertook an inductive or deductive route of the group norm and value internalization. This study represents an important contribution to the study of social identity and the process by which identities are formed, particularly under conditions of duress or significant organizational disruption.

Bioecological factors influencing women's alcohol consumption across the life span

Background Substantial changing trends in women’s alcohol consumption show increased proportions women drinking at risky/ high risk levels. Not confined to the younger female population, these increases are also occurring in older female age groups (aged 35 and over), posing a set of risks differing to those of their male counterparts. However, little research investigates the influences behind these changing trends. The current research examined multiple level influences (i.e. cultural, social and psychosocial on women’s drinking across a range of age groups. Methods Semi-structured telephone interviews were conducted with thirty-five women (aged 18-55) residing in Australia. Interview development was guided by an adaptation of Bronfenbrenner’s Bioecological Model of Development to assess multiple areas of influences from cultural through to psychosocial (i.e. intra-individual). Each interview took approximately 1 hour to complete. Findings Bronfenbrenner’s Bioecological Model could account for multiple-level factors impacting women’s drinking with multidirectional influences interacting across each level. Cultural influences included gender roles and national identity. Exosystem influences (e.g. infrastructure, legislation, and media) and microsystem influences (e.g. drinking context, family, partner and peer influence) were clearly identified as impacting drinking behaviours. Finally, at the psychosocial level, attitudes and expectations around the disinhibiting effects of alcohol and social facilitation emerged as key influences. Discussion The outcomes indicated the importance of these influences as women’s alcohol-related attitudes and behaviours changed across a woman’s life span and across age cohorts. Future research will build on these initial findings in order to underpin targeted interventions of the key factors influencing women’s drinking.

Exploring cultural, social and psychosocial influences on women's drinking across the life span

Background Changing trends in women's alcohol consumption have demonstrated that women, in both younger and older cohorts, are drinking at increased levels than previously. However, little research investigates these changing trends or the influences behind them. Aims The current research aims to identify influences on women's drinking across a range of age groups, with a focus on multiple level influences (i.e. cultural, social and psychosocial). Methods One hour semi-structured telephone interviews were conducted, in 2011, with 35 women (aged 18-55) residing in Australia. Interview development was guided by an adaptation of Bronfenbrenner's Bioecological Model of Development (BBMD) to assess multiple areas of influences from cultural through to psychosocial. Results Interview findings highlighted the existence of multiple levels of influence on women’s drinking and thus provided support for the BBMD framework. Cultural influences identified related to gender roles and national identity. Exosystem influences (e.g. legislation, infrastructure, and media) and Microsystem influences (e.g. immediate social networks) were also identified. A range of psychosocial factors, such as identity, normative influence and attitude were also found as influencing drinking behaviours. Finally, changes across a woman’s life span, and intergenerational differences, were Chronosystem constructs that also emerged as key influences. Discussion and conclusions This study has provided an in-depth understanding into the key factors, occurring across multiple levels of influence, impacting upon women's drinking across younger and older cohorts. The findings also highlight changes in alcohol-related attitudes and behaviours across a life span and across generations. Future research should extend upon these findings based on larger, quantitative studies based on representative samples. The findings do provide key insights into the influences that need to be addressed within targeted interventions.

Bioequivalence of two tablet formulations of capecitabine and exploration of age, gender, body surface area, and creatinine clearance as factors influencing systemic exposure in cancer patients

Purpose: The objective of the study was to assess the bioequivalence of two tablet formulations of capecitabine and to explore the effect of age, gender, body surface area and creatinine clearance on the systemic exposure to capecitabine and its metabolites. Methods: The study was designed as an open, randomized two-way crossover trial. A single oral dose of 2000 mg capecitabine was administered on two separate days to 25 patients with solid tumors. On one day, the patients received four 500-mg tablets of formulation B (test formulation) and on the other day, four 500-mg tablets of formulation A (reference formulation). The washout period between the two administrations was between 2 and 8 days. After each administration, serial blood and urine samples were collected for up to 12 and 24 h, respectively. Unchanged capecitabine and its metabolites were determined in plasma using LC/MS-MS and in urine by NMRS. Results: Based on the primary pharmacokinetic parameter, AUC(0-∞) of 5'-DFUR, equivalence was concluded for the two formulations, since the 90% confidence interval of the estimate of formulation B relative to formulation A of 97% to 107% was within the acceptance region 80% to 125%. There was no clinically significant difference between the t(max) for the two formulations (median 2.1 versus 2.0 h). The estimate for C(max) was 111% for formulation B compared to formulation A and the 90% confidence interval of 95% to 136% was within the reference region 70% to 143%. Overall, these results suggest no relevant difference between the two formulations regarding the extent to which 5'-DFUR reached the systemic circulation and the rate at which 5'-DFUR appeared in the systemic circulation. The overall urinary excretions were 86.0% and 86.5% of the dose, respectively, and the proportion recovered as each metabolite was similar for the two formulations. The majority of the dose was excreted as FBAL (61.5% and 60.3%), all other chemical species making a minor contribution. Univariate and multivariate regression analysis to explore the influence of age, gender, body surface area and creatinine clearance on the log-transformed pharmacokinetic parameters AUC(0-∞) and C(max) of capecitabine and its metabolites revealed no clinically significant effects. The only statistically significant results were obtained for AUC(0-∞) and C(max) of intact drug and for C(max) of FBAL, which were higher in females than in males. Conclusion: The bioavailability of 5'-DFUR in the systemic circulation was practically identical after administration of the two tablet formulations. Therefore, the two formulations can be regarded as bioequivalent. The variables investigated (age, gender, body surface area, and creatinine clearance) had no clinically significant effect on the pharmacokinetics of capecitabine or its metabolites.

Plaintext awareness in identity-based key encapsulation

The notion of plaintext awareness ( PA ) has many applications in public key cryptography: it offers unique, stand-alone security guarantees for public key encryption schemes, has been used as a sufficient condition for proving indistinguishability against adaptive chosen-ciphertext attacks ( IND-CCA ), and can be used to construct privacy-preserving protocols such as deniable authentication. Unlike many other security notions, plaintext awareness is very fragile when it comes to differences between the random oracle and standard models; for example, many implications involving PA in the random oracle model are not valid in the standard model and vice versa. Similarly, strategies for proving PA of schemes in one model cannot be adapted to the other model. Existing research addresses PA in detail only in the public key setting. This paper gives the first formal exploration of plaintext awareness in the identity-based setting and, as initial work, proceeds in the random oracle model. The focus is laid mainly on identity-based key encapsulation mechanisms (IB-KEMs), for which the paper presents the first definitions of plaintext awareness, highlights the role of PA in proof strategies of IND-CCA security, and explores relationships between PA and other security properties. On the practical side, our work offers the first, highly efficient, general approach for building IB-KEMs that are simultaneously plaintext-aware and IND-CCA -secure. Our construction is inspired by the Fujisaki-Okamoto (FO) transform, but demands weaker and more natural properties of its building blocks. This result comes from a new look at the notion of γ -uniformity that was inherent in the original FO transform. We show that for IB-KEMs (and PK-KEMs), this assumption can be replaced with a weaker computational notion, which is in fact implied by one-wayness. Finally, we give the first concrete IB-KEM scheme that is PA and IND-CCA -secure by applying our construction to a popular IB-KEM and optimizing it for better performance.

Luxury brand identity : the influence of mobile digital technology

This thesis examined the influence of mobile digital technology on the brand identity of luxury brands. Specifically it focused on the use of mobile applications by automobile, hotel and beauty brands and compared the perceptions of marketing managers with consumers on how mobile applications influenced luxury brand identity and image. Outcomes of this research included a model to depict the ongoing process between mobile-mediated luxury brand identity and image, and a typology of luxury brand mobile applications listing key features of mobile-mediated luxemosphere. Overall findings suggest that the influence of mobile applications on luxury brand identity has been negative, as their brand image appeared to be degraded, resulting in diminishing the brand identity.

Networked identity work as project development among co-creative communities

Networked identity work is the conscious negotiation or co-creation of identity, enacted by speaking and listening across differences among multiple publics, including those real and imagined, familiar and unknown, on and offline, present and future. It is a concept I explore extensively in research with queer Digital Storytellers who share their personal stories in public places to catalyse social change (Vivienne 2013). In this article I consider distinctions between ‘story’ and ‘identity’; ‘networking’ and ‘networked identity work’ and argue that the two concepts may be usefully employed in development of co-creative community projects. Finally I consider how variable definitions of co-creativity influence project development.

Gender studies : Intersex by Catherine Harper

Intersex is the condition whereby an individual is born with biological features that are simultaneously perceived as male and female. Ranging from the ambiguous genitalia of the true 'hermaphrodite' to the 'mildly or internally intersexed', the condition may be as common as cleft palate. Like cleft palate, it is hidden and surgically altered, but for very different reasons. Intersex draws heavily on the personal testimony of intersexed individuals, their loved ones and medical carers. The impact of early sex-assignment surgery on an individual's later life is examined within the context of ethical and clinical questions. Harper challenges the conventional and radical 'treatment' of intersexuality through non-consensual infant sex-assignment surgery. In doing so, she exposes powerful myths, taboos and constructions of gender - the perfect phallus, a bi-polar model of gender and the infallibility of medical decisions. Handling sensitive material with care, this book deepens our understanding of a condition that has itself only been medically understood in recent years.

The serious and playful work of gender : talk and social order in a preschool classroom

This chapter reports some observations made of the social interactions of girls and boys, aged 3 to 5 years, in play situations in a preschool classroom of a childcare centre. It provides an alternate framework for early childhood educators to become aware of how preschool children construct their gendered social organizations. As girls and boys organise and build their social worlds of play through their talk-in-interaction, they are building their social orders. In this chapter, an analysis of one episode of children's play has, as its focus , the methods that some girls and boys use in their talk and activity to make sense of their everyday interactions. The analysis of play shows the children's real life work of constructing and maintaining gendered social orders in their lived everyday social worlds. A close reading of the transcript of an episode illustrates how two girls turn they boys' masculine practices o ritualized threats into performance. By so doing, they show that while they know masculine discourse, and can perform it themselves, they do not actually 'own' it in the same way that the boys do. In this way, gender is established not as a social density but as a shaped dynamic practice that is ongoing, build by relational encounters and shaped by the collective performances of the participants.