Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

The Ideological Transformation of the Icon Chairman Mao during the Four Modernisations period : As illustrated by "Melody of Youth, Beautiful Soul"

After Chairman Mao's death, in the late 1980's, Mao was removed from official government communications and his iconography transformed from having a specific meaning generation role linked to Maoist ideology, to becoming available for use as a commodity. In this research I use cultural theorist Jacques Derrida's theory of Hauntology and the deconstruction method to analyse a representative Chinese Propaganda poster, "Melody of Youth, Beautiful Soul", in order to ascertain the effect Mao's death had on the Iconography of Chairman Mao, and how Mao is ideologically transformed during this period. Analysing the painting I found specific symbols associated with the iconography of Mao that had been adopted and transformed for the purposes of the CCP. These symbols both suggested the presence of Chairman Mao, as well as negated that presence through being co-opted for other purposes. Using these symbols and writings about the period I deduced that during this period the CCP had to rely on existing symbols of power and authority in order to communicate and legitimise regime change whilst maintaining the semblance of continuity. At the same time they had to decouple these symbols from their original meanings in order to distance themselves from the past and redefine the ideology of China. In the process, Mao's iconography was decoupled from its Maoist ideological heritage and transformed into abstract symbols of power, doctrine and so on. This means that the transformation had made them available to use as an "open basket" into which new, related meanings could be placed – including serving as a commodity.

The effects of taxing truck distance on CO2 emissions from transports in retailing

To finance transportation infrastructure and to address social and environmental negative externalities of road transports, several countries have recently introduced or consider a distance based tax on trucks. In the competitive retail market such tax can be expected to lower the demand and thereby reduce CO2 emissions of road transports. However, as we show in this paper, such tax might also slow down the transition towards e-tailing. Considering that previous research indicates that a consumer switching from brick-and-mortar shopping to e-tailing reduces her CO2 emissions substantially, the direction and magnitude of the environmental net effect of the tax is unclear. In this paper, we assess the net effect in a Swedish regional retail market where the tax not yet is in place. We predict the net effect on CO2 emissions to be positive, but off-set by about 50% because of a slower transition to e-tailing.

The effect on CO2 emissions of taxing truck distance in retail transports

To finance transportation infrastructure and to address social and environmental negative externalities of road transports, several countries have recently introduced or consider a distance based tax on trucks. In competitive retail and transportation markets, such tax can be expected to lower the demand and thereby reduce CO2 emissions of road transports. However, as we show in this paper, such tax might also slow down the transition towards e-tailing. Considering that previous research indicates that a consumer switching from brick-and-mortar shopping to e-tailing reduces her CO2 emissions substantially, the direction and magnitude of the environmental net effect of the tax is unclear. In this paper, we assess the net effect in a Swedish regional retail market where the tax not yet is in place. We predict the net effect on CO2 emissions to be positive, but off-set by about 50% because of a slower transition to e-tailing.