Raising the voice of dissatisfaction : a qualitative study of the Queensland acute health care consumer and the experience of complaining

Research into complaints handling in the health care system has predominately focused on examining the processes that underpin the organisational systems. An understanding of the cognitive decisions made by patients that influence whether they are satisfied or dissatisfied with the care they are receiving has had limited attention thus far. This study explored the lived experiences of Queensland acute care patients who complained about some aspect of their inpatient stay. A purposive sample of sixteen participants was recruited and interviewed about their experience of making a complaint. The qualitative data gathered through the interview process was subjected to an Interpretative Phenomenological Analysis (IPA) approach, guided by the philosophical influences of Heidegger (1889-1976). As part of the interpretive endeavour of this study, Lazarus’ cognitive emotive model with situational challenge was drawn on to provide a contextual understanding of the emotions experienced by the study participants. Analysis of the research data, aided by Leximancer™ software, revealed a series of relational themes that supported the interpretative data analysis process undertaken. The superordinate thematic statements that emerged from the narratives via the hermeneutic process were ineffective communication, standards of care were not consistent, being treated with disrespect, information on how to complain was not clear, and perceptions of negligence. This study’s goal was to provide health services with information about complaints handling that can help them develop service improvements. The study patients articulated the need for health care system reform; they want to be listened to, to be acknowledged, to be believed, for people to take ownership if they had made a mistake, for mistakes not to occur again, and to receive an apology. For these initiatives to be fully realised, the paradigm shift must go beyond regurgitating complaints data metrics in percentages per patient contact, towards a concerted effort to evaluate what the qualitative complaints data is really saying. An opportunity to identify a more positive and proactive approach in encouraging our patients to complain when they are dissatisfied has the potential to influence improvements.

On forward secrecy in one-round key exchange

Most one-round key exchange protocols provide only weak forward secrecy at best. Furthermore, one-round protocols with strong forward secrecy often break badly when faced with an adversary who can obtain ephemeral keys. We provide a characterisation of how strong forward secrecy can be achieved in one-round key exchange. Moreover, we show that protocols exist which provide strong forward secrecy and remain secure with weak forward secrecy even when the adversary is allowed to obtain ephemeral keys. We provide a compiler to achieve this for any existing secure protocol with weak forward secrecy.

The exchange: an experiment in environmentally sustainable urban practice for a subtropical climate

The exchange pavilion offers a dialogue between two Expositions: 1998 in Brisbane and 2010 in Shanghai; and a chance to examine the impact that climate change will have on urban best practice outcomes in cities of the future. The Exchange exhibits the proposition that environmentally sustainable buildings need to interact responsively with a range of technical innovations to enable communities (and hence cities) to control and better manage their immediate environment. The 'Exchange' pavilion is a design experiment that integrates 3 key research elements: * An interactive digital exchange * A living green system wall (vertical and temporal) * A public urban star (horizontal and spatial) The proposition argues that the environmentally sustainability of any city is reliant on harnessing the full spectrum of intellectual and creative capital of the winder community (from universities to Government bodies to citizens) - a true knowledge city.

Towards a provably secure DoS-Resilient key exchange protocol with perfect forward secrecy

Just Fast Keying (JFK) is a simple, efficient and secure key exchange protocol proposed by Aiello et al. (ACM TISSEC, 2004). JFK is well known for its novel design features, notably its resistance to denial-of-service (DoS) attacks. Using Meadows’ cost-based framework, we identify a new DoS vulnerability in JFK. The JFK protocol is claimed secure in the Canetti-Krawczyk model under the Decisional Diffie-Hellman (DDH) assumption. We show that security of the JFK protocol, when reusing ephemeral Diffie-Hellman keys, appears to require the Gap Diffie-Hellman (GDH) assumption in the random oracle model. We propose a new variant of JFK that avoids the identified DoS vulnerability and provides perfect forward secrecy even under the DDH assumption, achieving the full security promised by the JFK protocol.

Value co-creation in social marketing wellness services

Customer perceived value is concerned with the experiences of consumers when using a service and is often referred to in the context of service provision or on the basis of service quality (Auh, et al., 2007; Chang, 2008; Jackson, 2007; Laukkanen, 2007; Padgett & Mulvey, 2007; Shamdasani, Mukherjee & Malhotra, 2008). Understanding customer perceived value has benefits for social marketing and allows scholars and practitioners alike to identify why consumers engage in positive social behaviours through the use of services. Understanding consumers’ use of wellness services in particular is important, because the use of wellness services demonstrates the fulfilment of social marketing aims; performing pro-active, positive social behaviours that are of benefit to the individual and to society (Andreasen, 1994). As consumers typically act out of self-interest (Rothschild, 1999), this research posits that a value proposition must be made to consumers in order to encourage behavioural change. Thus, this research seeks to identify how value is created for consumers of wellness services in social marketing. This results in the overall research question of this research: How is value created in social marketing wellness services? A traditional method towards understanding value has been the adoption of an economic approach, which considers the utility gained and where value is a direct outcome of a cost-benefit analysis (Payne & Holt, 1999). However, there has since been a shift towards the adoption of an experiential approach in understanding value. This experiential approach considers the consumption experience of the consumer which extends beyond the service exchange and includes pre- and post-consumption stages (Russell-Bennett, Previte & Zainuddin, 2009). As such, this research uses an experiential approach to identify the value that exists in social marketing wellness services. Four dimensions of value have been commonly conceptualised and identified in the commercial marketing literature; functional, emotional, social, and altruistic value (Holbrook, 1994; Sheth, Newman & Gross, 1991; Sweeney & Soutar, 2001). It is not known if these value dimensions also exist in social marketing. In addition, sources of value said to influence value dimensions have been conceptualised in the literature. Sources of value such as information, interaction, environment, service, customer co-creation, and social mandate have been conceptually identified both in the commercial and social marketing literature (Russell-Bennet, Previte & Zainuddin, 2009; Smith & Colgate, 2007). However, it is not clear which sources of value contribute to the creation of value for users of wellness services. Thus, this research seeks to explore these relationships. This research was conducted using a wellness service context, specifically breast cancer screening services. The primary target consumer of these services is women aged 50 to 69 years old (inclusive) who have never been diagnosed with breast cancer. It is recommended that women in this target group have a breast screen every 2 years in order to achieve the most effective medical outcomes from screening. A two-study mixed method approach was utilised. Study 1 was a qualitative exploratory study that analysed individual-depth interviews with 25 information-rich respondents. The interviews were transcribed verbatim and analysed using NVivo 8 software. The qualitative results provided evidence of the existence of the four value dimensions in social marketing. The results also allowed for the development of a typology of experiential value by synthesising current understanding of the value dimensions, with the activity aspects of experiential value identified by Holbrook (1994) and Mathwick, Malhotra and Rigdon (2001). The qualitative results also provided evidence for the existence of sources of value in social marketing, namely information, interaction, environment and consumer participation. In particular, a categorisation of sources of value was developed as a result of the findings from Study 1, which identify organisational, consumer, and third party sources of value. A proposed model of value co-creation and a set of hypotheses were developed based on the results of Study 1 for further testing in Study 2. Study 2 was a large-scale quantitative confirmatory study that sought to test the proposed model of value co-creation and the hypotheses developed. An online-survey was administered Australia-wide to women in the target audience. A response rate of 20.1% was achieved, resulting in a final sample of 797 useable responses after removing ineligible respondents. Reliability and validity analyses were conducted on the data, followed by Exploratory Factor Analysis (EFA) in PASW18, followed by Confirmatory Factor Analysis (CFA) in AMOS18. Following the preliminary analyses, the data was subject to Structural Equation Modelling (SEM) in AMOS18 to test the path relationships hypothesised in the proposed model of value creation. The SEM output revealed that all hypotheses were supported, with the exception of one relationship which was non-significant. In addition, post hoc tests revealed seven further significant non-hypothesised relationships in the model. The quantitative results show that organisational sources of value as well as consumer participation sources of value influence both functional and emotional dimensions of value. The experience of both functional and emotional value in wellness services leads to satisfaction with the experience, followed by behavioural intentions to perform the behaviour and use the service again. One of the significant non-hypothesised relationships revealed that emotional value leads to functional value in wellness services, providing further empirical evidence that emotional value features more prominently than functional value for users of wellness services. This research offers several contributions to theory and practice. Theoretically, this research addresses a gap in the literature by using social marketing theory to provide an alternative method of understanding individual behaviour in a domain that has been predominantly investigated in public health. This research also clarifies the concept of value and offers empirical evidence to show that value is a multi-dimensional construct with separate and distinct dimensions. Empirical evidence for a typology of experiential value, as well as a categorisation of sources of value is also provided. In its practical contributions, this research identifies a framework that is the value creation process and offers health services organisations a diagnostic tool to identify aspects of the service process that facilitate the value creation process.

Exploring regional differences in Chinese consumer acceptance of new mobile technology : a qualitative study

This study examines consumer adoption of 3G mobile technology in China. The qualitative study involved 45 in-depth interviews undertaken in three major Chinese cities to explore the beliefs and attitudes which determine Chinese consumers’ acceptance of the mobile technological innovation. The findings are compared and contrasted against those reported in Western studies. The variations underpinning adoption of 3G between consumers in the three regional cities were identified. Specifically, it was found that the regions differed in terms of the relative importance of the identified adoption determinants, such as perceived social outcomes for using the innovation and the effects of social influence on the adoption. These findings provide subtle insight into the nature of Chinese consumers’ responses to new mobile technologies and a better understanding of variations among regional Chinese consumers.

Modeling key compromise impersonation attacks on group key exchange protocols

Two-party key exchange (2PKE) protocols have been rigorously analyzed under various models considering different adversarial actions. However, the analysis of group key exchange (GKE) protocols has not been as extensive as that of 2PKE protocols. Particularly, an important security attribute called key compromise impersonation (KCI) resilience has been completely ignored for the case of GKE protocols. Informally, a protocol is said to provide KCI resilience if the compromise of the long-term secret key of a protocol participant A does not allow the adversary to impersonate an honest participant B to A. In this paper, we argue that KCI resilience for GKE protocols is at least as important as it is for 2PKE protocols. Our first contribution is revised definitions of security for GKE protocols considering KCI attacks by both outsider and insider adversaries. We also give a new proof of security for an existing two-round GKE protocol under the revised security definitions assuming random oracles. We then show how to achieve insider KCIR in a generic way using a known compiler in the literature. As one may expect, this additional security assurance comes at the cost of an extra round of communication. Finally, we show that a few existing protocols are not secure against outsider KCI attacks. The attacks on these protocols illustrate the necessity of considering KCI resilience for GKE protocols.

The two faces of normative commitment : a qualitative study of the dual nature of normative commitment

Organisational commitment is extensively represented in the human resource management and organisational behaviour literature as a key factor in the relationship between employees and their organisations. Although Allen and Meyer (1990) noted that an employee can experience the three components of organisational commitment simultaneously, in terms of commitment profiles, the majority of studies have looked at the antecedents and outcomes of affective, continuance, and normative commitment independently. There is still only limited research that has investigated the nature of commitment profiles and their implications for employee work-related behaviours (Gellatly Meyer and Luchak 2006; Herscovitch & Meyer 2002; Somers 2010; Wasti 2005). An area where the commitment profiles approach potentially provides new insights is on the nature of normative commitment.

Anonymity and one-way authentication in key exchange protocols

Key establishment is a crucial cryptographic primitive for building secure communication channels between two parties in a network. It has been studied extensively in theory and widely deployed in practice. In the research literature a typical protocol in the public-key setting aims for key secrecy and mutual authentication. However, there are many important practical scenarios where mutual authentication is undesirable, such as in anonymity networks like Tor, or is difficult to achieve due to insufficient public-key infrastructure at the user level, as is the case on the Internet today. In this work we are concerned with the scenario where two parties establish a private shared session key, but only one party authenticates to the other; in fact, the unauthenticated party may wish to have strong anonymity guarantees. We present a desirable set of security, authentication, and anonymity goals for this setting and develop a model which captures these properties. Our approach allows for clients to choose among different levels of authentication. We also describe an attack on a previous protocol of Øverlier and Syverson, and present a new, efficient key exchange protocol that provides one-way authentication and anonymity.

An analysis of the qualitative characteristics of management commentary reporting by New Zealand companies

The narrative section of annual reports has considerable value to its user groups, such as financial analysts and investors (Tiexiera, 2004; Barlett and Chandler, 1997, IASB, 2006). This narrative section including chairpersons’/presidents’ statement contains twice the quantity of information than the financial statements section (Smith and Taffler, 2000). However, the abundance of information does not necessarily enhance the quality of such information (IASB, 2006). This issue of qualitative characteristics has been long foregone by researchers. This issue has attracted the attention of IASB (2006). Following the dearth in research in regard to qualitative characteristics of reporting this paper explores whether investors’ required qualitative characteristics as outlined by the IASB (2006) have been satisfied in management commentary section of New Zealand companies’ annual reports. Our result suggests that the principal stakeholders’, that is, investors’ qualitative characteristics requirements have been partially met in this section of annual reports. The qualitative characteristic of ‘relevance’ and ‘supportability’ have been satisfied in more annual reports compared to that of ‘balance’ and ‘comparability.’

From barrier elimination to barrier negotiation : a qualitative study of parents' attitudes about active travel for elementary school trips

This paper examines parents' responses to key factors associated with mode choices for school trips. The research was conducted with parents of elementary school students in Denver Colorado as part of a larger investigation of school travel. School-based active travel programs aim to encourage students to walk or bike to school more frequently. To that end, planning research has identified an array of factors associated with parents' decisions to drive children to school. Many findings are interpreted as ‘barriers’ to active travel, implying that parents have similar objectives with respect to travel mode choices and that parents respond similarly and consistently to external conditions. While the conclusions are appropriate in forecasting demand and mode share with large populations, they are generally too coarse for programs that aim to influence travel behavior with individuals and small groups. This research uses content analysis of interview transcripts to examine the contexts of factors associated with parents' mode choices for trips to and from elementary school. Short, semi-structured interviews were conducted with 65 parents from 12 Denver Public Elementary Schools that had been selected to receive 2007–08 Safe Routes to School non-infrastructure grants. Transcripts were analyzed using Nvivo 8.0 to find out how parents respond to selected factors that are often described in planning literature as ‘barriers’ to active travel. Two contrasting themes emerged from the analysis: barrier elimination and barrier negotiation. Regular active travel appears to diminish parents' perceptions of barriers so that negotiation becomes second nature. Findings from this study suggest that intervention should build capacity and inclination in order to increase rates of active travel.

Towards general capabilities through technology : assessment for learning as a field of exchange

The introduction of the Australian curriculum, the use of standardised testing (e.g. NAPLAN) and the My School website have stimulated and in some cases renewed a range of boundaries for young people in Australian Education. Standardised testing has accentuated social reproduction in education with an increase in the numbers of students disengaging from mainstream education and applying for enrolment at the Edmund Rice Education Australia Flexible Learning Centre Network (EREAFLCN). Many young people are denied access to credentials and certification as they become excluded from standardised education and testing. The creativity and skills of marginalised youth are often evidence of general capabilities and yet do not appear to be recognised in mainstream educational institutions when standardised approaches are adopted. Young people who participate at the EREAFLCN arrive with a variety of forms of cultural capital, frequently utilising general capabilities, which are not able to be valued in current education and employment fields. This is not to say that these young people‟s different forms of cultural capital have no value, but rather that such funds of knowledge, repertoires and cultural capital are not valued by the majority of powerful agents in educational and employment fields. How then can the inherent value of traditionally unorthodox - yet often intricate, ingenious, and astute-versions of cultural capital evident in the habitus of many young people be made to count, be recognised, be valuated?Can a process of educational assessment be a field of capital exchange and a space which crosses boundaries through a valuating process? This paper reports on the development of an innovative approach to assessment in an alternative education institution designed for the re engagement of „at risk‟ youth who have left formal schooling. A case study approach has been used to document the engagement of six young people, with an educational approach described as assessment for learning as a field of exchange across two sites in the EREAFLCN. In order to capture the broad range of students‟ cultural and social capital, an electronic portfolio system (EPS) is under trial. The model draws on categories from sociological models of capital and reconceptualises the eportfolio as a sociocultural zone of learning and development. Results from the trial show a general tendency towards engagement with the EPS and potential for the attainment of socially valued cultural capital in the form of school credentials. In this way restrictive boundaries can be breached and a more equitable outcome achieved for many young Australians.

Turning histories into futures : assessment for learning as a field of exchange

Standardised testing does not recognise the creativity and skills of marginalised youth. Young people who come to the Edmund Rice Education Australia Flexible Learning Centre Network (EREAFLCN) in Australia arrive with forms of cultural capital that are not valued in the field of education and employment. This is not to say that young people‟s different modes of cultural capital have no value, but rather that such funds of knowledge, repertoires and cultural capital are not valued by the powerful agents in educational and employment fields. The forms of cultural capital which are valued by these institutions are measurable in certain structured formats which are largely inaccessible for what is seen in Australia to be a growing segment of the community. How then can the inherent value of traditionally unorthodox - yet often intricate, adroit, ingenious, and astute - versions of cultural capital evident in the habitus of many young people be made to count, be recognised, be valuated? Can a process of educational assessment be used as a marketplace, a field of capital exchange? This paper reports on the development of an innovative approach to assessment in an alternative education institution designed for the re-engagement of „at risk‟ youth who have left formal schooling. In order to capture the broad range of students‟ cultural and social capital, an electronic portfolio system (EPS) is under trial. The model draws on categories from sociological models of capital and reconceptualises the eportfolio as a sociocultural zone of learning and development. Initial results from the trial show a general tendency towards engagement with the EPS and potential for the attainment of socially valued cultural capital in the form of school credentials.

Integrating complementary and alternative therapies into psychological practice : A qualitative analysis

Although complementary and alternative therapies (CATs) are utilised widely for treating psychological disorders, little research has examined psychologists' beliefs about integrating CAT into psychological practice. Six practicing psychologists and six psychology students were interviewed about their CAT integration beliefs, in particular integrating CAT into clinical practice via recommending CATs, offering referrals to CAT practitioners, or undertaking training to utilise CATs within psychological practice. Guided broadly from a theory of planned behaviour perspective, participants raised a number of costs and benefits, discussed referent groups who would influence their decisions, and suggested motivators and barriers for integration. A number of additional themes were raised, including risks, such as the possibility of litigation and the need for clear Society guidelines, as most participants were unclear about what constitutes appropriate practice. Identifying these themes serves as an important initial step to informing discussion and policy for this emerging practice issue within psychology.

Evaluation of an Australian solar community : implications for education and training

1.1 Background What is renewable energy education and training? A cursory exploration of the International Solar Energy Society website (www.ises.org) reveals numerous references to education and training, referring collectively to concepts of the transfer and exchange of information and good practices, awareness raising and skills development. The purposes of such education and training relate to changing policy, stimulating industry, improving quality control and promoting the wider use of renewable energy sources. The primary objective appears to be to accelerate a transition to a better world for everyone (ISEE), as the greater use of renewable energy is seen as key to climate recovery; world poverty alleviation; advances in energy security, access and equality; improved human and environmental health; and a stabilized society. The Solar Cities project – Habitats of Tomorrow – aims at promoting the greater use of renewable energy within the context of long term planning for sustainable urban development. The focus is on cities or communities as complete systems; each one a unique laboratory allowing for the study of urban sustainability within the context of a low carbon lifestyle. The purpose of this paper is to report on an evaluation of a Solar Community in Australia, focusing specifically on the implications (i) for our understandings and practices in renewable energy education and training and (ii) for sustainability outcomes. 1.2 Methodology The physical context is a residential Ecovillage (a Solar Community) in sub-tropical Queensland, Australia (latitude 28o south). An extensive Architectural and Landscape Code (A&LC) ‘premised on the interconnectedness of all things’ and embracing ‘both local and global concerns’ governs the design and construction of housing in the estate: all houses are constructed off-ground (i.e. on stumps or stilts) and incorporate a hybrid approach to the building envelope (mixed use of thermal mass and light-weight materials). Passive solar design, gas boosted solar water heaters and a minimum 1kWp photovoltaic system (grid connected) are all mandatory, whilst high energy use appliances such as air conditioners and clothes driers are not permitted. Eight families participated in an extended case study that encompassed both quantitative and qualitative approaches to better understand sustainable housing (perceived as a single complex technology) through its phases of design, construction and occupation. 1.3 Results The results revealed that the level of sustainability (i.e. the performance outcomes in terms of a low-carbon lifestyle) was impacted on by numerous ‘players’ in the supply chain, such as architects, engineers and subcontractors, the housing market, the developer, product manufacturers / suppliers / installers and regulators. Three key factors were complicit in the level of success: (i) systems thinking; (ii) informed decision making; and (iii) environmental ethics and business practices. 1.4 Discussion The experiences of these families bring into question our understandings and practices with regard to education and training. Whilst increasing and transferring knowledge and skills is essential, the results appear to indicate that there is a strong need for expanding our education efforts to incorporate foundational skills in complex systems and decision making processes, combined with an understanding of how our individual and collective values and beliefs impact on these systems and processes.