Grunt language versus accent : the perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments

Due to the chronic shortages of GPs in Australian rural and remote regions, considerable numbers of international medical graduates (IMG) have been recruited. IMG experience many difficulties when relocating to Australia with one of the most significant being effective GP-patient communication. Given that this is essential for effective consultation it can have a substantial impact on health care. A purposive sample of seven practising GPs (five IMG, two Australian-trained doctors (ATD)) was interviewed using a semistructured face-to-face interviewing technique. GPs from Nigeria, Egypt, United Kingdom, India, Singapore and Australia participated. Interviews were transcribed and then coded. The authors used qualitative thematic analysis of interview transcripts to identify common themes. IMG-patient communication barriers were considered significant in the Wheatbelt region as identified by both IMG and ATD. ATD indicated they were aware of IMG-patient communication issues resulting in subsequent consults with patients to explain results and diagnoses. Significantly, a lack of communication between ATD and IMG also emerged, creating a further barrier to effective communication. Analysis of the data generated several important findings that rural GP networks should consider when integrating new IMG into the community. Addressing the challenges related to cross-cultural differences should be a priority, in order to enable effective communication. More open communication between ATD and IMG about GP-patient communication barriers and education programs around GP-patient communication would help both GP and patient satisfaction.

The value of books : the fantastic flying books of Mr. Morris Lessmore and the social hieroglyphic of reading

The late eighteenth century witnessed the emergence of new technologies of subjectivity and of the literary. Most obviously, “the novel as a literary form appeared to embody and turn into an object the experience of life itself” (Park), and the novel genre came to both reflect and shape notions of interiority and subjectivity. In this same period, “A shift was taking place in the way people felt and thought about children and the accoutrements of childhood, including books and toys, were implicated in this change” (Lewis). In seeking to understand the relationships between media (e.g. books and toys), genres (e.g. novels and picture books), and modes of subjectivity, Marx’s influential theory of commodity fetishism, whereby “a definite social relation between men, that assumes, in their eyes, the fantastic form of a relation between things”, has served as a productive tool of analysis. The extent to which Marx’s account of commodity fetishism continues to be of use becomes clear when the corollaries between the late eighteenth-century emergence of novels and pictures books as technologies of subjectivity and the early twenty-first century emergence of e-readers and digital texts as technologies of subjectivity are considered. This paper considers the literary technology of Apple’s iPad (first launched in 2010) as a commodity fetish, and the circulation of “apps” as texts made available by and offered as justifications for, this fetish object. The iPad is both book and toy, but is never “only” either; it is arguably a new technology of subjectivity which incorporates but also destabilises categories of reading and playing such as those made familiar by earlier technologies of literature and the self. The particular focus of this paper is on the multimodal versions (app, film, and picture book) of The Fantastic Flying Books of Mr. Morris Lessmore, which are understood here as a narrativisation of commodity fetishism, subjectivity, and the act of reading itself.

The effects of portal website attitude and e-services on branding of e-stores

Purpose –Increasingly the company websites, along with the intermediary websites such as portal sites have become an integral component of the firms brand strategy. This study emphasises the importance of website service elements within portal sites and the impact on e-retailer brand attitudes and brand identity in an ever more competitive digital market-space. Design/methodology/approach– The research employs structural equation modeling technique to capture the relationship among website attitude, e-service quality, brand attitude and brand identity. Findings–The results from the study indicate consumer attitude perceptions toward portal website and e-service elements combine to increase brand attitude and also brand identity for e-retailers. Originality/value –Although there has been a plethora of studies evaluating corporate websites and branding interactions there is limited comprehension of the impact of intermediary portal sites. Moreover, the literature is limited in validating the link between e-services with brand attitude and brand identity within a portal website context. This study develops a framework that highlights the important influence of e-services within portal websites and the impact on the firm’s brand.

Understanding IT value : a multilevel, complex, and adaptive system perspective

One remaining difficulty in the Information Technology (IT) business value evaluation domain is the direct linkage between IT value and the underlying determinants of IT value or surrogates of IT value. This paper proposes a research that examines the interacting effects of the determinants of IT value, and their influences on IT value. The overarching research question is how those determinants interact with each other and affect the IT value at organizational value. To achieve this, this research embraces a multilevel, complex, and adaptive system view, where the IT value emerges from the interacting of underlying determinants. This research is theoretically grounded on three organizational theories – multilevel theory, complex adaptive systems theory, and adaptive structuration theory. By integrating those theoretical paradigms, this research proposes a conceptual model that focuses on the process where IT value is created from interactions of those determinants. To answer the research question, agent-based modeling technique is used in this research to build a computational representation based on the conceptual model. Computational experimentation will be conducted based on the computational representation. Validation procedures will be applied to consolidate the validity of this model. In the end, hypotheses will be tested using computational experimentation data.

Antecedents of consumer brand loyalty in the Chilean wine industry

The wine industry has become fiercely competitive worldwide, and consumers are increasingly exposed to a wider range of wines in retail outlets. Therefore, wineries need to develop and build consumer loyalty toward their brands. The authors empirically test a model of wine brand loyalty in a Latin American context which considers wine brand trust, brand satisfaction, wine knowledge and wine experience as antecedents. Hypotheses are tested with structural equation modeling (SEM). Findings show that wine experience is positively related to brand trust and brand satisfaction. In addition, results show that consumer satisfaction with a wine brand is the strongest driver of brand loyalty.

Pixel value to electron density conversion for a Megavoltage Cone Beam CT System

Introduction: The motivation for developing megavoltage (and kilovoltage) cone beam CT (MV CBCT) capabilities in the radiotherapy treatment room was primarily based on the need to improve patient set-up accuracy. There has recently been an interest in using the cone beam CT data for treatment planning. Accurate treatment planning, however, requires knowledge of the electron density of the tissues receiving radiation in order to calculate dose distributions. This is obtained from CT, utilising a conversion between CT number and electron density of various tissues. The use of MV CBCT has particular advantages compared to treatment planning with kilovoltage CT in the presence of high atomic number materials and requires the conversion of pixel values from the image sets to electron density. Therefore, a study was undertaken to characterise the pixel value to electron density relationship for the Siemens MV CBCT system, MVision, and determine the effect, if any, of differing the number of monitor units used for acquisition. If a significant difference with number of monitor units was seen then pixel value to ED conversions may be required for each of the clinical settings. The calibration of the MV CT images for electron density offers the possibility for a daily recalculation of the dose distribution and the introduction of new adaptive radiotherapy treatment strategies. Methods: A Gammex Electron Density CT Phantom was imaged with the MVCB CT system. The pixel value for each of the sixteen inserts, which ranged from 0.292 to 1.707 relative electron density to the background solid water, was determined by taking the mean value from within a region of interest centred on the insert, over 5 slices within the centre of the phantom. These results were averaged and plotted against the relative electron densities of each insert with a linear least squares fit was preformed. This procedure was performed for images acquired with 5, 8, 15 and 60 monitor units. Results: The linear relationship between MVCT pixel value and ED was demonstrated for all monitor unit settings and over a range of electron densities. The number of monitor units utilised was found to have no significant impact on this relationship. Discussion: It was found that the number of MU utilised does not significantly alter the pixel value obtained for different ED materials. However, to ensure the most accurate and reproducible MV to ED calibration, one MU setting should be chosen and used routinely. To ensure accuracy for the clinical situation this MU setting should correspond to that which is used clinically. If more than one MU setting is used clinically then an average of the CT values acquired with different numbers of MU could be utilized without loss in accuracy. Conclusions: No significant differences have been shown between the pixel value to ED conversion for the Siemens MV CT cone beam unit with change in monitor units. Thus as single conversion curve could be utilised for MV CT treatment planning. To fully utilise MV CT imaging for radiotherapy treatment planning further work will be undertaken to ensure all corrections have been made and dose calculations verified. These dose calculations may be either for treatment planning purposes or for reconstructing the delivered dose distribution from transit dosimetry measurements made using electronic portal imaging devices. This will potentially allow the cumulative dose distribution to be determined through the patient’s multi-fraction treatment and adaptive treatment strategies developed to optimize the tumour response.

Business in troubled waters : does adverse attitude affect firm value?

This paper investigates the relationship between US MNCs' valuations and anti-Americanism in countries where MNCs' foreign subsidiaries are located. We find that MNCs suffer value-destruction when they enter markets where people express severe anti-Americanism. However, we uncover that geographic diversification into these high anti-Americanism countries significantly increases firm value if the MNC has high levels of intangibles such as technological know-how and marketing expertise. Our findings are consistent with the notion that the advantages from internalizing the cross-border transfer of intangibles are greater when barriers to competition are higher.

The role of perceived usefulness and attitude on electronic health record acceptance : an empirical investigation using response surface analysis

Information and communications technologies are a significant component of the healthcare domain and electronic health records play a major role within it. As a result, it is important that they are accepted en masse by healthcare professionals. How healthcare professionals perceive the usefulness of electronic health records and their attitudes towards them have been shown to have significant effects on their overall acceptance. This paper investigates the role of perceived usefulness and attitude on the intention to use electronic health records by future healthcare professionals using polynomial regression with response surface analysis. Results show that the relationship is more complex than predicted in prior research. The paper concludes that the predicting properties of the above determinants must be further investigated to clearly understand their role in predicting the intention to use electronic health records and in designing systems that are better adopted by healthcare professionals of the future.

Integration-segregation decisions under general value functions: "create your own bundle - choose 1, 2, or all 3!",

Whether to keep products segregated (e.g., unbundled) or integrate some or all of them (e.g., bundle) has been a problem of profound interest in areas such as portfolio theory in finance, risk capital allocations in insurance and marketing of consumer products. Such decisions are inherently complex and depend on factors such as the underlying product values and consumer preferences, the latter being frequently described using value functions, also known as utility functions in economics. In this paper, we develop decision rules for multiple products, which we generally call ‘exposure units’ to naturally cover manifold scenarios spanning well beyond ‘products’. Our findings show, e.g. that the celebrated Thaler's principles of mental accounting hold as originally postulated when the values of all exposure units are positive (i.e. all are gains) or all negative (i.e. all are losses). In the case of exposure units with mixed-sign values, decision rules are much more complex and rely on cataloging the Bell number of cases that grow very fast depending on the number of exposure units. Consequently, in the present paper, we provide detailed rules for the integration and segregation decisions in the case up to three exposure units, and partial rules for the arbitrary number of units.

PCV13 Perceptions of health during pregnancy increase the risk of cardiovascular disease

OBJECTIVES: To examine the prospective association between perception of health during pregnancy and cardiovascular risk factor of mothers 21 years after the index pregnancy. METHODS: Data used were from the Mater University Study of Pregnancy (MUSP), a community- based prospective birth ohort study begun in Brisbane, Australia, in 1983. Logistic regression analyses were conducted. RESULTS: Data were available for 3692 women. Women who perceived themselves as not having a straight forward pregnancy had twice the odds (adjusted OR 2.0, 95% CI 1.1-3.8) of being diagnosed with heart disease 21 years after the indexpregnancyascomparedtowomenwith a straight forward pregnancy. Apart from that, women who had complications (other than serious pregnancy complications) during the pregnancy were also at30%increased odds (adjustedOR 1.3, 95% CI 1.0-1.6) of having hypertension 21 years later. CONCLUSIONS: As a whole, our study suggests that pregnant women who perceived that they had complications and did not have a straight forward pregnancy are likely to experience poorer cardiovascular outcomes 21 years after the pregnancy.

Vision, Viability and Value: Three perspectives on the performing arts across cultures, context and nations

How can we reach out to institutions, artists and audiences with sometimes radically different agendas to encourage them to see, participate in and support the development of new practices and programs in the performing arts? In this paper, based on a plenary panel at PSi#18 Performance Culture Industry at the University of Leeds, Clarissa Ruiz (Columbia), AnuradhaKapur (India) and Sheena Wrigley (England) together with interloctorBree Hadley (Australia) speak about their work in as policy-makers, managers and producers in the performing arts in Europe, Asia and America over the past several decades. Acknowledged trailblazers in their fields, Ruiz, Kapur and Wrigley all have a commitment to creating a vital, viable and sustainable performing arts ecologies. Each has extensive experience in performance, politics, and the challenging process of managing histories, visions, stakeholders, and sometimes scarce resources to generate lasting benefits for the various communities have worked for, with and within. Their work, cultivating new initiatives, programs or policy has made them expert at brokering relationships in and in between private, public and political spheres to elevate the status of and support for performing arts as a socially and economically beneficial activity everyone can participate in. Each gives examples from their own practice to provide insight into how to negotiate the interests of artistic, government, corporate, community and education partners, and the interests of audiences, to create aesthetic, cultural and / or economic value. Together, their views offer a compelling set of perspectives on the changing meanings of the ‘value of the arts’ and the effects this has had for the artists that make and arts organisations that produce and present work in a range of different regional, national and cross-national contexts.

The role of intensity of interval training on fat oxidation and eating behaviour in overweight/obese men

The increasing prevalence of obesity in society has been associated with a number of atherogenic risk factors such as insulin resistance. Aerobic training is often recommended as a strategy to induce weight loss, with a greater impact of high-intensity levels on cardiovascular function and insulin sensitivity, and a greater impact of moderate-intensity levels on fat oxidation. Anaerobic high-intensity (supramaximal) interval training has been advocated to improve cardiovascular function, insulin sensitivity and fat oxidation. However, obese individuals tend to have a lower tolerance of high-intensity exercise due to discomfort. Furthermore, some obese individuals may compensate for the increased energy expenditure by eating more and/or becoming less active. Recently, both moderate- and high-intensity aerobic interval training have been advocated as alternative approaches. However, it is still uncertain as to which approach is more effective in terms of increasing fat oxidation given the issues with levels of fitness and motivation, and compensatory behaviours. Accordingly, the objectives of this thesis were to compare the influence of moderate- and high-intensity interval training on fat oxidation and eating behaviour in overweight/obese men. Two exercise interventions were undertaken by 10-12 overweight/obese men to compare their responses to study variables, including fat oxidation and eating behaviour during moderate- and high-intensity interval training (MIIT and HIIT). The acute training intervention was a methodological study designed to examine the validity of using exercise intensity from the graded exercise test (GXT) - which measured the intensity that elicits maximal fat oxidation (FATmax) - to prescribe interval training during 30-min MIIT. The 30-min MIIT session involved 5-min repetitions of workloads 20% below and 20% above the FATmax. The acute intervention was extended to involve HIIT in a cross-over design to compare the influence of MIIT and HIIT on eating behaviour using subjective appetite sensation and food preference through the liking and wanting test. The HIIT consisted of 15-sec interval training at 85 %VO2peak interspersed by 15-sec unloaded recovery, with a total mechanical work equal to MIIT. The medium term training intervention was a cross-over 4-week (12 sessions) MIIT and HIIT exercise training with a 6-week detraining washout period. The MIIT sessions consisted of 5-min cycling stages at ±20% of mechanical work at 45 %VO2peak, and the HIIT sessions consisted of repetitive 30-sec work at 90 %VO2peak and 30-sec interval rests, during identical exercise sessions of between 30 and 45 mins. Assessments included a constant-load test (45 %VO2peak for 45 mins) followed by 60-min recovery at baseline and the end of 4-week training, to determine fat oxidation rate. Participants’ responses to exercise were measured using blood lactate (BLa), heart rate (HR) and rating of perceived exertion (RPE) and were measured during the constant-load test and in the first intervention training session of every week during training. Eating behaviour responses were assessed by measuring subjective appetite sensations, liking and wanting and ad libitum energy intake. Results of the acute intervention showed that FATmax is a valid method to estimate VO2 and BLa, but is not valid to estimate HR and RPE in the MIIT session. While the average rate of fat oxidation during 30-min MIIT was comparable with the rate of fat oxidation at FATmax (0.16 ±0.09 and 0.14 ±0.08 g/min, respectively), fat oxidation was significantly higher at minute 25 of MIIT (P≤0.01). In addition, there was no significant difference between MIIT and HIIT in the rate of appetite sensations after exercise, but there was a tendency towards a lower rate of hunger after HIIT. Different intensities of interval exercise also did not affect explicit liking or implicit wanting. Results of the medium-term intervention indicated that current interval training levels did not affect body composition, fasting insulin and fasting glucose. Maximal aerobic capacity significantly increased (P≤0.01) (2.8 and 7.0% after MIIT and HIIT respectively) during GXT, and fat oxidation significantly increased (P≤0.01) (96 and 43% after MIIT and HIIT respectively) during the acute constant-load exercise test. RPE significantly decreased after HIIT greater than MIIT (P≤0.05), and the decrease in BLa was greater during the constant-load test after HIIT than MIIT, but this difference did not reach statistical significance (P=0.09). In addition, following constant-load exercise, exercise-induced hunger and desire to eat decreased after HIIT greater than MIIT but were not significant (p value for desire to eat was 0.07). Exercise-induced liking of high-fat sweet (HFSW) and high-fat non-sweet (HFNS) foods increased after MIIT and decreased after HIIT (p value for HFNS was 0.09). The intervention explained 12.4% of the change in fat intake (p = 0.07). This research is significant in that it confirmed two points in the acute study. While the rate of fat oxidation increased during MIIT, the average rate of fat oxidation during 30-min MIIT was comparable with the rate of fat oxidation at FATmax. In addition, manipulating the intensity of acute interval exercise did not affect appetite sensations and liking and wanting. In the medium-term intervention, constant-load exercise-induced fat oxidation significantly increased after interval training, independent of exercise intensity. In addition, desire to eat, explicit liking for HFNS and fat intake collectively confirmed that MIIT is accompanied by a greater compensation of eating behaviour than HIIT. Findings from this research will assist in developing exercise strategies to provide obese men with various training options. In addition, the finding that overweight/obese men expressed a lower RPE and decreased BLa after HIIT compared with MIIT is contrary to the view that obese individuals may not tolerate high-intensity interval training. Therefore, high-intensity interval training can be advocated among the obese adult male population. Future studies may extend this work by using a longer-term intervention.

Postgraduate response to an information retrieval credit course

Information skills instruction for research candidates bas recently been formalised as coursework at the Queensland University of Technology. Feedback solicited from participants suggests that students benefit from such coursework in a number of ways. Their perception of the value of specific content areas to their literature review and thesis presentation is favourable. A small group of students who participated in Interviews identified five ways in which the coursework assisted the research process. As Instructors continue to work with the post·graduate community it would be useful to deepen our understanding of how such instruction is perceived and the benefits which can be derived from it.

Self-reported likelihood of speeding : the effects of attitudes, personality, and perceived legitimacy of enforcement

The positive relationship between speed and crash risk and severity is robust and well-established. While excessive speeding is typically regarded by the public as a common contributing factor in road crashes, speeding remains a common traffic infringement and an arguably socially acceptable behaviour, particularly at low levels over the speed limit. This suggests that other factors potentially contribute to this disparity between crash perceptions and actual behaviours. Previous work has described associations between perceptions of the legitimacy of speed enforcement, attitudes, and how they relate to the likelihood of speeding. This study sought to more closely examine the nature of the relationships between these variables. In total, 293 Queensland drivers participated in a study that examined how demographics, personality variables, attitudes, and perceptions of the legitimacy of enforcement contributed to drivers’ self-reported likelihood of speeding. Results suggested that positive attitudes towards speeding had the greatest impact on likelihood of speeding behaviours. Being younger and higher levels of the personality trait of extraversion were also associated with greater levels of self-reported likelihood of speeding. Attitudes were found to mediate the relationship between perceived legitimacy of speed enforcement and self-reported likelihood of speeding. A subgroup analysis of participants with positive and negative attitudes towards speeding revealed that a differential set of variables were predictive of self-reported likelihood of speeding for the two subgroups. This highlights the potential importance of attitudes in understanding the influence of perceptions of legitimacy of speed enforcement on speeding behaviour, and the need for targeted rather than a ‘one size fits all’ approach to changing attitudes and ultimately behaviour. The findings of the current study help to further understand why some drivers continue to speed.

Perceived environmental correlates and physical activity: What neighborhood aspects really matter for mothers and fathers of young children?

Limited research has been conducted with at-risk populations in examining perceived environmental correlates of physical activity (PA); thus, we examined this relationship among parents with young children, a group at risk for physical inactivity. Parents (252 mothers, 206 fathers) completed a questionnaire assessing measures of perceived neighborhood environment and a 1-week follow-up of PA behavior. Mothers were more likely than fathers to perceive their neighborhood as unsafe to go for walks at night and less likely to perceive transit stops within 10–15 minutes walking distance, sidewalks on most streets, and facilities to bicycle. Adjusting for demographics, shops within easy walking distance, sidewalks on most streets, and having no more than one motor vehicle were associated with being active for both sexes. Access to transit stops and free/low cost recreational facilities were also associated with mothers’ PA. These findings suggest that environmental factors may support parents being active at recommended levels.