The emerging role of private health care provision in China : a critical analysis of the current health system

China continues to face great challenges in meeting the health needs of its large population. The challenges are not just lack of resources, but also how to use existing resources more efficiently, more effectively, and more equitably. Now a major unaddressed challenge facing China is how to reform an inefficient, poorly organized health care delivery system. The objective of this study is to analyze the role of private health care provision in China and discuss the implications of increasing private-sector development for improving health system performance. This study is based on an extensive literature review, the purpose of which was to identify, summarize, and evaluate ideas and information on private health care provision in China. In addition, the study uses secondary data analysis and the results of previous study by the authors to highlight the current situation of private health care provision in one province of China. This study found that government-owned hospitals form the backbone of the health care system and also account for most health care service provision. However, even though the public health care system is constantly trying to adapt to population needs and improve its performance, there are many problems in the system, such as limited access, low efficiency, poor quality, cost inflation, and low patient satisfaction. Currently, private hospitals are relatively rare, and private health care as an important component of the health care system in China has received little policy attention. It is argued that policymakers in China should recognize the role of private health care provision for health system performance, and then define and achieve an appropriate role for private health care provision in helping to respond to the many challenges facing the health system in present-day China.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Objective To assess the effects of the 2011 floods in Brisbane, Australia, on residents’ physical and mental health. Methods Residents who had been affected by the floods completed a community-based survey that examined the direct impact of flooding on households and their perceived physical and mental health. Outcome variables included overall and respiratory health and mental health outcomes related to psychological distress, sleep quality, and posttraumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and perceived health outcome variables, adjusted for current health status and sociodemographic factors. Results Residents whose households were directly affected by flooding were more likely to report poor overall (Odds Ratio [OR] 5.3; 95% CI, 2.8-10.1) and respiratory (OR 2.3; 95% CI, 1.1-4.6) health, psychological distress (OR 1.9; 95% CI, 1.1-3.5), poor sleep quality (OR 2.3; 95% CI, 1.2-4.4), and probable PTSD (OR 2.3; 95% CI, 1.2-4.5). Conclusions The 2011 Brisbane floods had significant impact on the physical and psychosocial health of residents. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts, particularly those related to mental health.

The trials and tribulations of a BYOD science classroom

The increase in the availability and use of portable mobile devices has had a number of impacts on society. In particular, this impact has been seen within Higher Education Institutions where staff and students are using these devices for both simple and complex tasks. Within undergraduate teacher education courses there is an expectation that students will be fully prepared for teaching their respective areas of expertise as well as having the ability to use ICT, and in particular portable mobile devices, to support teaching and learning. This paper reports on a small case study into the use of portable mobile devices in a science unit, where the students (N=16) bring their own devices into the classroom and use them in lectures, tutorials and workshops. The study highlights the changing nature of classroom practice within the university setting and the challenges faced by teaching staff and students when using these devices.

Transnational higher education programs for facilitating inter-university knowledge transfer : University of Indonesia’s experience

This paper explores the impacts and extent of knowledge transfer (KT) in an undergraduate engineering transnational program with an Australian university partner at the University of Indonesia (UI) using an inter-university KT conceptual framework (Sutrisno, Lisana, & Pillay 2012). For the purpose of this paper, the opportunity for KT in curriculum design is examined. Given the explicit nature of curriculum knowledge, assessing each partner’s curriculum was pivotal in allowing UI to enrich its own curriculum. The KT mechanism of face-to-face contact between Indonesian and Australian academics led to not only transfer of knowledge related to the curriculum of the undergraduate program but also to other cooperation beyond the transnational program in the form of joint research and joint supervision of post-graduate theses. Positive inter-university dynamics, such as trust and willingness to work together between the partners were underpinned by the presence of key actors from both sides at the earlier stages of the partnership. Retrospectively exploring the KT process in the UI’s transnational programs with its Australian partner suggests that there have been both structured and unstructured mechanisms, highlighting the ubiquitous and unbounded nature of KT between universities. While initially successful in facilitating KT, due to rapid succession of persons in charge of the program and the increasing focus on revenue generation, the useful lessons and practices unfortunately are being lost. Although the intention to use the transnational program for KT was always implied, it gradually was overlooked by newer staff members. Based on UI’s experience as the first provider of transnational program in Indonesia and other similar cases in China, seemingly transnational programs driven by short-term immediate financial return are unsuccessful in facilitating KT due to sensitivities to unfavourable economic situation. Those that remain operational and contribute to knowledge exchange between the partners apparently have genuine long-term engagement objective.

Spatial modelling of population health screening : the role of accessibility in predicting expected patient flows

This paper describes a generalised linear mixed model (GLMM) approach for understanding spatial patterns of participation in population health screening, in the presence of multiple screening facilities. The models presented have dual focus, namely the prediction of expected patient flows from regions to services and relative rates of participation by region- service combination, with both outputs having meaningful implications for the monitoring of current service uptake and provision. The novelty of this paper lies with the former focus, and an approach for distributing expected participation by region based on proximity to services is proposed. The modelling of relative rates of participation is achieved through the combination of different random effects, as a means of assigning excess participation to different sources. The methodology is applied to participation data collected from a government-funded mammography program in Brisbane, Australia.

Calling for help : a responsive evaluation of Child Health Line

The project examined the responsiveness of the telenursing service provided by the Child Health Line (hereinafter referred to as CHL). It aimed to provide an account of population usage of the service, the call request types and the response of the service to the calls. In so doing, the project extends the current body of knowledge pertaining to the provision of parenting support through telenursing. Approximately 900 calls to the CHL were audio-recorded over the December 2005-2006 Christmas-New Year period. A protocol was developed to code characteristics of the call, the interactional features between the caller and nurse call-taker, and the extent to which there was (a) agreement on problem definition and the plan of action and (b) interactional alignment between nurse and caller. A quantitative analysis examined the frequencies of the main topics covered in calls to the CHL and any statistical associations between types of calls, length of calls and nurse-caller alignment. In addition, a detailed qualitative analysis was conducted on a subset of calls dealing with the nurse management of calls seeking medical advice and information. Key findings include: • Overall, 74% of the calls discussed parenting and child development issues, 48% discussed health/medical issues, and 16% were information-seeking calls. • More specifically: o 21% discussed health/medical and parenting and child development issues. o 3% discussed parenting and information-seeking issues. o 5% discussed health/medical, parenting/development and information issues. o 18% exclusively focussed on health and medical issues and therefore were outside the remit of the intended scope of the CHL. These calls caused interactional dilemmas for the nurse call-takers as they simultaneously dealt with parental expectations for help and the CHL guidelines indicating that offering medical advice was outside the remit of the service. • Most frequent reasons for calling were to discuss sleep, feeding, normative infant physical functions and parenting advice. • The average length of calls to the CHL was 7 minutes. • Longer calls were more likely to involve nurse call-takers giving advice on more than one topic, the caller displaying strong emotions, the caller not specifically providing the reason for the call, and the caller discussing parenting and developmental issues. • Shorter calls were characterised by the nurse suggesting that the child receive immediate medical attention, the nurse emphasising the importance or urgency of the plan of action, the caller referring to or requesting confirmation of a diagnosis, and caller and nurse call-taker discussion of health and medical issues. • The majority of calls, 92%, achieved parent-nurse alignment by the conclusion of the call. However, 8% did not. • The 8% of calls that were not aligned require further quantitative and qualitative investigation of the interactional features. The findings are pertinent in the current context where Child Health Line now resides within 13HEALTH. These findings indicate: 1. A high demand for parenting advice. 2. Nurse call-takers have a high level of competency in dealing with calls about parenting and normal child development, which is the remit of the CHL. 3. Nurse call-takers and callers achieve a high degree of alignment when both parties agree on a course of action. 4. There is scope for developing professional practice in calls that present difficulties in terms of call content, interactional behaviour and call closure. Recommendations of the project: 1. There are numerous opportunities for further research on interactional aspects of calls to the CHL, such as further investigations of the interactional features and the association of the features to alignment and nonalignment. The rich and detailed insights into the patterns of nurse-parent interactions were afforded by the audio-recording and analysis of calls to the CHL. 2. The regular recording of calls would serve as a way of increasing understanding of the type and nature of calls received, and provide a valuable training resource. Recording and analysing calls to CHL provides insight into the operation of the service, including evidence about the effectiveness of triaging calls. 3. Training in both recognising and dealing with problem calls may be beneficial. For example, calls where the caller showed strong emotion, appeared stressed, frustrated or troubled were less likely to be rated as aligned calls. In calls where the callers described being ‘at their wits end’, or responded to each proposed suggestion with ‘I’ve tried that’, the callers were fairly resistant to advice-giving. 4. Training could focus on strategies for managing calls relating to parenting support and advice, and parental well-being. The project found that these calls were more likely to be rated as being nonaligned. 5. With the implementation of 13HEALTH, future research could compare nurse-parent interaction following the implementation of triaging. Of the calls, 21% had both medical and parenting topics discussed and 5.3% discussed medical, parenting and information topics. Added to this, in 12% of calls, there was ambiguity between the caller and nurse call-taker as to whether the problem was medical or behavioural.

The feral horse foot. Part B : radiographic, gross visual and histopathological parameters of foot health in 100 Australian feral horses

Background It has been proposed that the feral horse foot is a benchmark model for foot health in horses. However, the foot health of feral horses has not been formally investigated. Objectives To investigate the foot health of Australian feral horses and determine if foot health is affected by environmental factors, such as substrate properties and distance travelled. Methods Twenty adult feral horses from five populations (n = 100) were investigated. Populations were selected on the basis of substrate hardness and the amount of travel typical for the population. Feet were radiographed and photographed, and digital images were surveyed by two experienced assessors blinded to each other's assessment and to the population origin. Lamellar samples from 15 feet from three populations were investigated histologically for evidence of laminitis. Results There was a total of 377 gross foot abnormalities identified in 100 left forefeet. There were no abnormalities detected in three of the feet surveyed. Each population had a comparable prevalence of foot abnormalities, although the type and severity of abnormality varied among populations. Of the three populations surveyed by histopathology, the prevalence of chronic laminitis ranged between 40% and 93%. Conclusions Foot health appeared to be affected by the environment inhabited by the horses. The observed chronic laminitis may be attributable to either nutritional or traumatic causes. Given the overwhelming evidence of suboptimal foot health, it may not be appropriate for the feral horse foot to be the benchmark model for equine foot health.

Reliability of the Five Factor Wellness Inventory among male adolescents

Measuring adolescent wellness can assist researchers and practitioners in determining lifestyle behaviors in which adolescents are deficient. An appropriate objective assessment may assist male adolescents who feel uncomfortable revealing behaviors that may indicate wellness deficits. The authors examined the test-retest reliability of the Five Factor Wellness Inventory (5F-Wel) with a sample of male adolescents. Thirty-five participants self-completed the 5F-Wel on two separate occasions, 7 days apart. Limits of agreement, intraclass correlation coefficients, and paired t tests were calculated to investigate agreement and whether systematic differences existed between administrations. The initial findings indicate the 5F-Wel is reliable for use among male adolescents and support its use in research.

Plant structure and systematics research at the Queensland University of Technology (QUT), Brisbane

This article provides a general overview of some of the plant research being conducted by a number of researchers at the Queensland University of Technology (QUT) Brisbane. Details about student projects and research facilities have been limited to those of relevance to plant structure and systematics. Academics, technicians and research students involved in plant research are in the Faculty of Science and Engineering, mainly in the School of Earth, Environment and Biological Sciences (EEBS), with a few exceptions. Our offices and laboratories are housed in a number of different buildings at the Gardens Point campus (e.g., P, Q, R, S, M Blocks) and we have strong collaborative links with Queensland Herbarium (BRI) and Mt Coot-tha Botanic Gardens.

Information skills coursework for postgraduate students : investigation and response at the Queensland University of Technology

In response to current developments In the tertiary education sector, the Queensland University of Technology Library has mounted an Intensive course - Advanced Information Retrieval Skills - for higher degree students. In determining need for such a course, a survey of postgraduate students and their supervisors was conducted. Results of this survey are discussed and details of the four credit point subjects are outlined.

Predictors of mental health in post-menopausal women : results from the Australian healthy aging of women study

Objective: To examine the extent to which socio-demographics, modifiable lifestyle, and physical health status influence the mental health of post-menopausal Australian women. Methods: Cross-sectional data on health status, chronic disease and modifiable lifestyle factors were collected from a random cross-section of 340 women aged 60-70 years, residing in Queensland, Australia. Structural equation modelling (SEM) was used to measure the effect of a range of socio-demographic characteristics, modifiable lifestyle factors, and health markers (self-reported physical health, history of chronic illness) on the latent construct of mental health status. Mental health was evaluated using the Medical Outcomes Study Short Form 12 (SF-12®) which examined and Center for Epidemiologic Studies Depression Scale (CES-D). Results: The model was a good fit for the data (χ2=4.582, df=3, p=0.205) suggesting that mental health is negatively correlated with sleep disturbance (β = -0.612, p <0.001), and a history of depression (β = -0.141, p = 0.024).While mental health was associated with poor sleep, it was not correlated with most lifestyle factors (BMI, alcohol consumption, or cigarette smoking) or socio-demographics like age, income or employment category and they were removed from the final model. Conclusion: Research suggests that it is important to engage in a range of health promoting behaviours to preserve good health. We found that predictors of current mental health status included sleep disturbance, and past mental health problems, while socio-demographics and modifiable lifestyle had little impact. It may be however, that these factors influenced other variables associated with the mental health of post-menopausal women, and these relationships warrant further investigation.

Relationship of moderate and low isometric lumbar extension through architectural and muscular activity variables: a cross sectional study

Background No study relating the changes obtained in the architecture of erector spinae (ES) muscle were registered with ultrasound and different intensities of muscle contraction recorded by surface EMG (electromyography) on the ES muscle was found. The aim of this study was analyse the relationship in the response of the ES muscle during isometric moderate and light lumbar isometric extension considering architecture and functional muscle variables. Methods Cross-sectional study. 46 subjects (52% men) with a group mean age of 30.4 (±7.78). The participants developed isometric lumbar extension while performing moderate and low isometric trunk and hip extension in a sitting position with hips flexed 90 degrees and the lumbar spine in neutral position. During these measurements, electromyography recordings and ultrasound images were taken bilaterally. Bilaterally pennation angle, muscle thickness, torque and muscle activation were measured. This study was developed at the human movement analysis laboratory of the Health Science Faculty of the University of Malaga (Spain). Results Strong and moderate correlations were found at moderate and low intensities contraction between the variable of the same intensity, with correlation values ranging from 0.726 (Torque Moderate – EMG Left Moderate) to 0.923 (Angle Left Light – Angle Right Light) (p < 0.001). This correlation is observed between the variables that describe the same intensity of contraction, showing a poor correlation between variables of different intensities. Conclusion There is a strong relationship between architecture and function variables of ES muscle when describe an isometric lumbar extension at light or moderate intensity. Keywords: Ultrasonography; Surface electromyography; Thickness; Pennation angle; Erector spinae

The University of Queensland St Lucia campus 1.22 MW photovoltaic array

At the time of its official opening on 15 July 2011, The University of Queensland 1.22 MW array was the largest flat-panel PhotoVoltaic (PV) array in Australia. This PV array consists of over 5000 Trina Solar 240 Wp polycrystalline silicon PV modules installed across four rooftops at the St Lucia campus. Grid connection was achieved with 85 12.5 kW three phase and four 5 kW single phase grid connect inverters manufactured by Power-One. The site also includes one 8.4 kWp SolFocus concentrating solar 2 axis tracking PV array. Site wide monitoring and data logging of all DC, AC and environmental quantities will allow this array to be a rich source of research data. The site will also include a 200 kW 400 kWh zinc bromine energy storage system by Redflow, and associated power quality metering and monitoring. This paper presents highlights of the project feasibility study which included a site survey, shading analysis, and technology and triple bottom line assessment. A detailed description of the final technical implementation including discussion of alterative options considered is given. Finally, example initial data showing yield, trends and early example experimental results are presented.

Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer : lessons from the experience of a high-volume center

Objective: Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed. Methods: Three time periods were studied, 1990 to 1998 (period 1), 1999 to 2003 (period 2), and 2004 to 2008 (period 3), in which 471, 254, and 342 patients, respectively, with esophageal cancer were treated with curative intent. All data were prospectively recorded, and staging, pathology, treatment, operative, and oncologic outcomes were compared. Results: Five-year disease-specific survival was 28%, 35%, and 44%, and in-hospital postoperative mortality was 6.7%, 4.4%, and 1.7% for periods 1 to 3, respectively (P < .001). Period 3, compared with periods 1 and 2, respectively, was associated with significantly (P < .001) more early tumors (17% vs 4% and 6%), higher nodal yields (median 22 vs 11 and 18), and a higher R0 rate in surgically treated patients (81% vs 73% and 75%). The use of multimodal therapy increased (P < .05) across time periods. By multivariate analysis, age, T stage, N stage, vascular invasion, R status, and time period were significantly (P < .0001) associated with outcome. Conclusions: Improved survival with localized esophageal cancer in the modern era may reflect an increase of early tumors and optimized staging. Important surgical and pathologic standards, including a higher R0 resection rate and nodal yields, and lower postoperative mortality, were also observed. Copyright © 2012 by The American Association for Thoracic Surgery.

The University of Glasgow at Imageclefphoto 2009

In this paper we describe the approaches adopted to generate the five runs submitted to ImageClefPhoto 2009 by the University of Glasgow. The aim of our methods is to exploit document diversity in the rankings. All our runs used text statistics extracted from the captions associated to each image in the collection, except one run which combines the textual statistics with visual features extracted from the provided images. The results suggest that our methods based on text captions significantly improve the performance of the respective baselines, while the approach that combines visual features with text statistics shows lower levels of improvements.