Australia and Japan in the South Pacific island countries : a general appraisal through the concepts of structural power

This study examines several specific fields of activity of Australia and Japan in the areas of security, production, finance, development assistance, information, education and regional organization. Using the concept of structural power, it observes the sources of Australian and Japanese strenght in the region, the growing imbalance in the bilateral Australia-Japan relationship, and also the coexistence of affinities and differences in the development opportunities opened to the South Pacific Island Countries.

Entrepreneurship : industry policy priorities and entrepreneurial education in Australia

Four fields of national policy - general economic policy, industry policy, education policy and specific research and development policy - are strongly interrelated. Unfortunately, in Australia, policy makers in the four fields have not recognized that the discipline of Entrepreneurship - with its emphasis on managing the innovation process - holds the key to effective co-ordination between the four vital policy areas. The paper argues that innovation strategy, not cost reduction or research expenditure, is the key to developing successful, export-oriented products and world competitiveness. Viable innovation strategy depends on the relationship between government, capital availability, development capital and industrial developers. In turn, this relationship requires a cadre of entrepreneurial business managers educated not in the 'traditional' MBA mainstream but in the discipline of Entrepreneurship, specifically focused on learning the practical skills involved in venture evaluation and management of the innovation process. The paper concludes by describing the philosophy and performance of Swinburne University of Technology's School of Innovation and Enterprise, a school at the forefront of entrepreneurial education in Australia and thus a school with important implications for the nation's industry policy priorities.

Practice nurses' role and knowledge about diabetes management within rural and remote Australian general practices

Background: The increasing prevalence of diabetes and obesity represents a significant disease burden in Australia. Practice nurses (PNs) play an important role in diabetes education and management.

Aim: To explore PNs' roles, knowledge and beliefs about diabetes education and management in rural and remote general practice in Australia.

Method: Exploratory study undertaken in three phases: 1) Pilot study to test the performance of the questionnaire; 2) One-shot cross-sectional survey using self-complete questionnaires; 3) Individual interviews.

Results: Ten PNs completed the pilot test; the draft questionnaire was deemed appropriate to the study purpose. Then, 65 questionnaires were distributed to PNs and 21 responded. Fourteen respondents had worked in the role <5 years, and most PNs attended diabetes education programmes in their workplace. A minority (40%) used diabetes management guidelines regularly. Most knew obesity to be the most common risk factor for diabetes but only 50% knew that glycosylated haemoglobin indicates blood glucose levels over the preceding three months. Self-reported competency to assess patients' self-care practices and medication management practices varied.

Conclusion: PNs' diabetes management was self-reported; their knowledge varied and their perceived benefits of diabetes education differed from those of patients.

Is dietary management a responsibility of general practitioners? The views of Victorian general practitioners

Rationale : Australia is experiencing an evolving healthcare system, resulting in an aim of systematic managed care for patients with chronic disease. One outcome has been debate on doctors' dietary management responsibilities.
Aim : To identify general practitioners' perceptions of their dietary management responsibilities for adult cardiac patients.
Methods : A Two phase study was conducted. First, semi-structured interviews with 30 Melbourne general practitioners were conducted to gather preliminary information about dietary management. The results informed a questionnaire for the second phase. This was completed by 248 general practitioners (30%) in Victoria.
Principal findings : Themes arising in interviews, and also supported by cross-sectional survey showed that doctors perceive themselves as filling one or more of three roles. The majority (87.4%) endorsed an 'Influencing' role, 27.4% endorsed 'Dietary Educator' and 44.0% a 'Coordinator' role. The Influencer role was characterised by encouragement of dietary behaviour change, such as discussing benefits and consequences of inaction to dietary change. The Educator role was characterised by the provision of a range of behaviour change strategies- 'how to' achieve change. 'Coordinators' reported the provision of dietary counselling belonged to dietitians alone.
Implications : The results indicate doctors' awareness of need for patients' dietary education should be increased. This could be accomplished by one-on-one education. Patients' access to dietary education should also be facilitated by doctors' referring on. Embedding dietary management protocols in doctors' managed care templates could improve patients' access to dietary education and enhance doctor's collaborative roles.
Presentation type : Paper
Session theme : Getting Evidence into Practice 2

Nutrition care for adult cardiac patients : Australian general practitioners' perceptions of their role

Background. Australia has implemented systematic managed care for patients with chronic disease. Little is known about how GPs perceive their nutrition care role in this system.
Objective. To examine GPs’ perceptions of their roles in the nutrition care of cardiac patients and to identify factors that influence their role.
Methods. Multi-methods research design. Semi-structured interviews were conducted with a sample (n = 30) GPs Victoria, Australia. The resulting narratives were used to develop a quantitative questionnaire to survey a random sample of GPs. Principal components analysis was conducted to reduce the role items to a small number of underlying dimensions. The association between roles and demographic variables were examined using stepwise multiple regressions.
Results. In all, 248 GPs (30% response) participated. Three main roles were established: Influencing, Coordinating and Nutrition Educator role. Together, the roles explained 54% of the total variance. Demographic variables were not associated with these roles. The majority (mean = 88%) endorsed the items which loaded on to the Influencing and Coordinating (mean = 49%) roles. Short consultation time, use of prescribed medications and perception of patient attendance at cardiac rehabilitation reduced the priority for nutrition education.
Conclusions. This study highlights the importance of developing more effective team care arrangements for patients with chronic disease and working with the medical education colleges to develop education resources for doctors that include an explanation of the non-pharmaceutical as well as the pharmaceutical treatment for each chronic disease condition.

The relevance of the Heart Foundation of Australia's dietary recommendations for adult Australians : a comparison of views of general practitioners, cardiologists and dietitians

PURPOSE: To compare the views of general practitioners, cardiologists and dietitians about the relevance of the Heart Foundation of Australia's dietary recommendations for adult cardiac patients.

BASIC PROCEDURES: Quantitative-cross sectional study. Postal questionnaires were self-completed by 248 Victorian general practitioners (30% response), 189 Australia-wide cardiologists (47% response) and 180 Victorian dietitians (45% response). Responses were represented as percentages and analyses of variance were conducted to explore the impact of the independent variables: age, work status and gender on the dependent variable: dietary recommendation.

MAIN FINDINGS: Approximately half of the recommendations were viewed as strongly important to implement; these related to lean meats, limiting takeaways and cakes/biscuits, and adjusting energy intake. Others of importance were eating fruits, vegetables and fish. However, most of these goals were seen as difficult to achieve. Dietitians appeared to share responses of doctors, except for greater importance of eating fruit and vegetables and a greater difficulty in limiting cakes and biscuits. There was a high level of agreement among the three groups (mean 87%) about patients having difficulty implementing adjusting energy intake.

CONCLUSIONS: There is agreement amongst these professionals that many of the recommendations lack importance, specifically those pertaining to unsaturated oils, low fat dairy products, cholesterol rich foods, intake of legumes and grains and the restriction of salt. This may reflect a need for further nutrition education.

Enhancing the dietary management of general practice patients through collaborative care: perspectives of general practitioners and dietitians

Aim:  To describe how general practitioners and dietitians view their role in the dietary management of cardiac patients and to provide insights on how to facilitate collaborative care.
Methods:  Two studies were conducted in Victoria (Australia) 2005–2006. Study One: semi-structured interviews with general practitioners. Study Two: cross-sectional quantitative surveys of general practitioners and dietitians. Study One: texts were analysed using the grounded theory approach. Study Two: frequency analysis was conducted and chi-squared test for independence was used to explore the impact of age, sex and consultation time on the role and reporting scales.
Results:  Study One: Themes arising from the interviews with 30 general practitioners showed their involvement in dietary management fell into three broad roles: ‘Influencing’, ‘Coordinator’ of referrals and dietary ‘Educator’. They described dietetic education as a process that included dietary assessment, education, application of behavioural change techniques and reporting back to general practitioners. Study Two: Respondents were 248 general practitioners (30% response) and 180 dietitians (60% response). General practitioners' counselling consisted mostly of advocating for dietary change, coordinating dietetic referrals and reinforcing dietitians' recommendations. General practitioners considered dietary education as the role of dietitians. Dietitians reported a much broader role in the management of patients with some overlap with general practitioners' roles.
Conclusions:   The findings indicate the need: (i) for more structured reporting to ensure general practitioners receive appropriate information to enable them to reinforce dietetic counselling and recommendations; and (ii) to streamline the communication process in order to expedite dietitians' reports to general practitioners.

Occupational therapy students' attitudes towards inclusion education in Australia, United Kingdom, United States and Taiwan

This international, cross-cultural study investigated the attitudes of occupational therapy students from Australia, United Kingdom, United States and Taiwan towards inclusive education for students with disabilities. The possible impact of professional education on students' attitudes was also explored. A total of 485 students from 11 entry level occupational therapy education programmes from Australia, the United Kingdom, the United Sates and Taiwan participated in the study. Among them, 264 were freshmen (first-year students) and 221 were seniors (final-year students). Data collected from a custom-designed questionnaire were analysed both quantitatively and qualitatively.

In general, the occupational therapy students reported having positive attitudes towards inclusion. Considerable differences, however, existed among the student groups from the four countries. Professional education appeared to have a significant impact on students' attitudes towards inclusion from first year to senior year. Although students were in favour of inclusion, they also cautioned that their support for inclusive practices depended on various factors such as adequate preparation, support and assistance to students with disabilities.

Limitations of the study included the small, convenience sample and different degree structures of the participating programmes. Future research studies need to compare occupational therapy students' attitudes with students from other health care professions. A longitudinal study on the impact of the professional education programme on students' attitudes towards inclusive education is warranted.

Doing the ultimate public good through teacher education

It is argued here that the many public goods associated with education are derivatives of an ultimate good. This ultimate good is the overall purpose of life in general and is similar to a telos as understood in ancient Greek culture. This paper reviews the notions of ‘good' and telos, and examines implications of Bauman’s analysis of our present individualizing era, the role of personal meaning making and the nature of education. It is then argued that preservice teachers can do the ultimate public good in a postmodern society, by articulating a developed personal, professional perspective that expresses a purpose (telos) of life.

A model of organizational ethics education

Purpose – This paper aims to propose a model of ethics education for corporate organizations framed as an holistic approach to the problem of how to teach ethics.

Design/methodology/approach – As a conceptual/viewpoint piece, this paper recognizes that for ethics education to be successful, individuals and corporations must have an appreciation of their role in the society at large. In addition, there needs to be preparedness on the part of the corporation to engage in an ethical manner with the marketplace with which it interacts.

Findings – Ethics education should not exist in a vacuum, that is just within the organization, but it should reflect the values of the organization as they impact upon and are impacted upon by society in general.

Research/limitations/implications – This model is predicated on a belief that organizations must craft their ethics education program with as much care and enthusiasm as they craft their strategic plan. The employees are the organization's representatives and they need to be made as clear as one can make them as to the ethical philosophy of the company and what is expected of them. Adults have a capacity for greater reasoning and reflection on their life experiences than children and thus the concept of “andragogy” provides a more satisfactory method to fashion education programs for adults than some more traditional methods that focus on training and not education.

Practical implications – When considering the ethics education of its employees, corporations need to place that education in context as it relates to the organization and the wider society as a whole. It is suggested that an ethics education program needs to provide a framework for understanding the concepts of ethics and moral development. Using this framework as the basis for the education offered, the education program is then expanded into an examination of a range of ethical issues presented in a variety of ways.

Originality/value – This paper proposes an integrated way to approach ethics education that ensures that the antecedents of the program are considered in the context of the ethics of individuals, the society and in turn the organization, hence the holistic approach.

Restructuring teacher education, the national interest and globalisation

This paper argues that the repositioning of Asian countries as new 'centres' for world trade and commerce and the transformation of Australian society and economy to accord with this global consolidation, includes a general restructuring of all levels of Australia's 'education industry' and specifically the (re)forming of its initial teacher and professional-education programmes. The need for such reformation arises in part from the restructuring of the work of teaching based on a broader definition of the people and educational settings that are involved in the teaching/learning process, a reworking of this teaching/learning process, the higher status given to certain substantive areas of study, such as languages other than English, and the management of education along corporatist lines. This paper suggests further that teacher-education programmes should also provide students with the resources to critically analyse these changes, giving consideration to issues such as identity, the impact of new technologies on culture and learning, the use of language in promoting particular discourses, and the repositioning of education as a tool for economic reform.

What counts as higher education? Pursuing intellectually compelling ideas

A few months ago I was sitting in a graduation ceremony considering the nature of universities; what it means to do academic work and how this constitutes some higher form of education. Unlike some of my more astute colleagues who had remembered to bring their current reading (copies of Giroux or Gelemter nestled within their graduation programs) to while away the time between applauds for graduates and speeches, I was confined to my own thoughts on matters of importance for universities and their constituents. The ceremony provided critical moments for reflection--for me, centred around the politics of meaningmincluding: the presentation to a colleague of the Vice-Chancellor's award for teaching excellence; the conferring of an honorary doctorate on the guest speaker, Fiji's Prime Minister Major-General Rabuka, for his involvement in restructuring Fiji's system of governance; and the celebration of his visit by the Vice-Chancellor, himself a would-be reformer of systems as a member of the West Review of Australian higher education.

A prospective study of the effect of education on non-compliant behaviour in contact lens wear

The contact lens practitioner and patient present a specific case for the study of non-compliance in areas such as hygiene, solution use, appointment attendance and wearing times. Education is one of the factors thought to influence compliance among patients in general health care situations and contact lens practitioners are encouraged to educate patients in the care and maintenance of contact lenses. A prospective, randomized, controlled and double masked study was performed to assess the effect of a‘compliance enhancement strategy’ on levels of compliance among contact lens wearers over twelve months. Eighty experienced contact lens patients were randomly allocated to two experimental groups. A standard level of contact lens instruction was applied to the first group and in addition the compliance enhancement strategy was applied to patients assigned to the second group. The strategy consisted of extra education for patients using a video, booklets, posters, a checklist and a health care contract. Patients were given free supplies of RelMu multipurpose solution and Medalist 38 soft contact lenses IBausch and Lomb, Rochester. New York). Compliance levels were assessed at a twelve month aftercare appointment by demonstration and questionnaire. The results indicate that the compliance enhancement strategy had little significant effect on the compliance levels of the patients to whom it was applied. The population of contact lens wearers were generally very compliant and the contact lenses and care regimen were clinically successful. The possibility that the assessment of non–compliance was not adequately sensitive to highlight small differences in non-compliant, behaviour is discussed. The standard level of eduction applied to this sample of contact lens patients was adequate to ensure generally high levels of compliance with the simple care and maintenance regimen recommended.

Chronic disease and impairment among Alaska native elders : the Alaska Education and Research Towards Health (EARTH) study

Background: Chronic diseases and impairments are prevalent among older Americans. However, prevalence data for Alaska Native (AN) elders are limited, with estimates usually extrapolated from national studies in which AN elders may not be well-represented. The aim of this study was to describe the prevalence of selected chronic diseases, impairments, and measured medical risk factors among a large community sample of AN elders.

Methods: Design, setting, and participants. A community-based cross-sectional study of baseline information from 656 AN elders aged 55 years or over who participated in the Alaska Education and Research Towards Health (EARTH) Study, March 2004 to August 2006. Measurements. Self-reported lifetime prevalence of 17 doctor-diagnosed chronic diseases, and point prevalence of vision, hearing, oral, and general health impairment were estimated from data collected using audio computer-assisted self-administered questionnaires. In addition, height, weight, blood pressure, fasting blood lipids, and fasting blood glucose levels were measured.

Results: The four most prevalent chronic diseases among AN elders were high blood pressure (55%), arthritis (49%), high cholesterol (42%), and adult bone fracture/break (35%). The median number of chronic diseases reported was three (inter-quartile range, 2 to 5). The prevalence of self-reported vision impairment was 15%, hearing impairment 18%, and having had all natural teeth removed 25%. Almost 50% were obese. High blood pressure (systolic ≥ 140 mm Hg and/or diastolic ≥ 90 mm Hg) was measured in 23%, high low density lipoprotein (LDL) cholesterol (≥ 130 mg/dL) in 39%, and high fasting plasma glucose (> 125 mg/dL) in 9%. Obesity was more prevalent among women than men. There were also significant regional differences in rates of obesity and high LDL cholesterol.

Conclusion: These data may be useful in public health programs and health services planning.