Correlates of screening mammography for Italian and Anglo-Australian women

The first aim of the research was to determine the applicability of certain variables from the Health Belief Model (HBM), the Theory of Reasoned Action (TRA), the risk dimensions from the Psychometric Paradigm, the Common-Sense Model of Illness Representations and the Locus of Control to Italian women’s beliefs and behaviours in relation to screening mammography. These models have predominantly been derived and evaluated with English-speaking persons. The study used quantitative and qualitative methods to enable explanation of research-driven and participant-driven issues. The second aim was to include Italian women in health behaviour research and to contrast the Italian sample with the Anglo-Australian sample to determine if differences exist in relation to their beliefs. In Australia many studies in health behaviour research do not include women whose first language is not English. The third aim was to evaluate the Anti-Cancer Council of Victoria’s (ACCV) Community Language Program (CLP) by: (a) identifying the strengths and weaknesses of the program as seen by the participants; and (b) assessing the impact of the program on women’s knowledge and beliefs about breast cancer, early detection of breast cancer, self-reported and intended breast screening behaviours. The CLP is an information service that uses women’s first language to convey information to women whose first language is not English. The CLP was designed to increase knowledge about breast and cervical cancer. The research used a pre-test-intervention-post-test design with 174 Italian-born and 138 Anglo-Australian women aged 40 years and over. Interviews for the Italian sample were conducted in Italian. The intervention was an information session that related to breast health and screening mammography. Demographic variables were collected in the Pre-Test only. Qualitative open-ended questions that related specifically to the information session were collected in the Post-Test phase of the study. Direct logistic regression was used with the participants’ beliefs and behaviours to identify the relevant variables for language (Italian speaking and English-speaking), attendance to an information session, mammography screening and breast self-examination (BSE) behaviour. Pre- and Post-Test comparisons were conducted using chi-square tests for the non-parametric data and paired sample t-tests for the parametric data. Differences were found between the Italian and Anglo-Australian women in relation to their beliefs about breast cancer screening. The Italian women were: (1) more likely to state that medical experts understood the causes of breast cancer; (2) more likely to feel that they had less control over their personal risk of getting breast cancer; (3) more likely to be upset and frightened by thinking about breast cancer; (4) less likely to perceive breast cancer as serious; (4) more likely to only do what their doctor told them to do; and (5) less likely to agree that there were times when a person has cancer and they don’t know it. A pattern emerged for the Italian and Anglo-Australian women from the logistic regression analyses. The Italian women were much more likely to comply with medical authority and advice. The Anglo-Australian women were more likely to feel that they had some control over their health. Specifically, the risk variable ‘dread’ was more applicable to the Italian women’s behaviour and internal locus of control variable was more relevant to the Anglo-Australian women. The qualitative responses also differed for the two samples. The Italian women’s comments were more general, less specific, and more limited than that of the Anglo-Australian women. The Italian women talked about learning how to do BSE whereas the Anglo-Australian women said that attending the session had reminded them to do BSE more regularly. The key findings and contributions of the present research were numerous. The focus on one cultural group ensured comprehensive analyses, as did the inclusion of an adequate sample size to enable the use of multivariate statistics. Separating the Italian and Anglo-Australian samples in the analyses provided theoretical implications that would have been overlooked if the two groups were combined. The use of both qualitative and quantitative data capitalised on the strengths of both techniques. The inclusion of an Anglo-Australian group highlighted key theoretical findings, differences between the two groups and unique contributions made by both samples during the collection of the qualitative data. The use of a pre-test-intervention-post-test design emphasised the reticence of the Italian sample to participate and talk about breast cancer and confirmed and validated the consistency of the responses across the two interviews for both samples. The inclusion of non-cued responses allowed the researcher to identify the key salient issues relevant to the two groups. The limitations of the present research were the lack of many women who were not screening and reliance on self-report responses, although few differences were observed between the Pre- and Post-Test comparisons. The theoretical contribution of the HBM and the TRA variables was minimal in relation to screening mammography or attendance at the CLP. The applicability of these health behaviour theories may be less relevant for women today as they clearly knew the benefits of and the seriousness of breast cancer screening. The present research identified the applicability of the risk variables to the Italian women and the relevance of the locus of control variables to the Anglo-Australian women. Thus, clear cultural differences occurred between the two groups. The inclusion of the illness representations was advantageous as the responses highlighted ideas and personal theories salient to the women not identified by the HBM. The use of the illness representations and the qualitative responses further confirmed the relevance of the risk variables to the Italian women and the locus of control variables to the Anglo-Australian women. Attendance at the CLP did not influence the women to attend for mammography screening. Behavioural changes did not occur between the Pre- and Post-Test interviews. Small incremental changes as defined by the TTM and the stages of change may have occurred. Key practical implications for the CLP were identified. Improving the recruitment methods to gain a higher proportion of women who do not screen is imperative for the CLP promoters. The majority of the Italian and Anglo-Australian women who attended the information sessions were women who screen. The fact that Italian women do not like talking or thinking about cancer presents a challenge to promoters of the CLP. The key theoretical finding that Italian women dread breast cancer but comply with their doctor provides clear strategies to improve attendance at mammography screening. In addition, the inclusion of lay health advisors may be one way of increasing attendance to the CLP by including Italian women already attending screening and likely to have attended a CLP session. The present research identified the key finding that improving Anglo-Australian attendance at an information session is related to debunking the myth surrounding familial risk of breast cancer and encouraging the Anglo-Australian women to take more control of their health. Improving attendance for Italian women is related to reducing the fear and dread of breast cancer and building on the compliance pattern with medical authority. Therefore, providing an information session in the target language is insufficient to attract non-screeners to the session and then to screen for breast cancer. Suggestions for future research in relation to screening mammography were to include variables from more than one theory or model, namely the risk, locus of control and illness representations. The inclusion of non-cued responses to identify salient beliefs is advantageous. In addition, it is imperative to describe the profile of the cultural sample in detail, include detailed descriptions of the translation process and be aware of the tendency of Italian women to acquiesce with medical authority.

A note on work-related values, budget emphasis and managers’ organisational commitment

Managers’ work-related values (WRVs) have important implications for designing appropriate management accounting systems (MAS) in organisations. This paper examines the effect of the interaction between managers’ WRV for innovation and budget emphasis (an integral part of MAS) on their organisational commitment. The sample consisted of 109 managers from production, marketing and support departments within Australian manufacturing firms. Hypotheses were tested using both quantitative and qualitative data collected by a questionnaire survey and post-survey interviews. The results indicate that the adoption of low budget emphasis led to high organisational commitment when managers’ WRV for innovation was high, but not when managers’ WRV for innovation was low. The results also indicate that marketing managers held higher WRV for innovation than production managers. The post-survey interviews provide further insight into how a more customer- and competitor-focused subculture of marketing managers and a more technical- and efficiency-focused subculture of production managers may promote the difference in their WRV for innovation, and affect their attitudes towards budget emphasis. The findings of the study have implications for design of performance evaluation systems for managers in functionally differentiated organisations.

Perceptions of health, illness and physiotherapy of Maori identifying with Ngati Tama iwi

The purpose of this study was to explore the perceptions of health, illness and the delivery of physiotherapy amongst a group of contemporary Maori. The methodology was established in collaboration with Kaumatua of the Ngati iwi. This resulted in the data collection consisting of semi-structured interviews, which used open-ended questions. As with other studies of cultural health issues both quantitative and qualitative data were collected. Nineteen people identifying with this iwi volunteered to participate. The majority of participants had some involvement in the Maori culture. All participants had used the western orthodox health system, with approximately 50% of them having also used traditional Maori methods of healing. Their perceptions of health and illness beliefs reflected a mixture of western orthodox medicine theories and traditional Maori beliefs. Despite only 10 participants having experienced physiotherapy, the majority had a good understanding of what physiotherapy is. While those who had received physiotherapy regarded it positively, there was a general feeling amongst the participants that it could be delivered in a more culturally sensitive manner. This did not necessarily mean that Maori people wanted to be treated at a clinic on the Marae or by Maori physiotherapists.

Developing english skills through reflective portfolios in Hong Kong universities

This research concerns the use of portfolios by teachers of English (L2) to assist non-native speakers in Hong Kong universities to complete their studies in English. Portfolios as an English learning tool have yet to win converts from the ranks of language teachers in Hong Kong chiefly because of concerns about reliability and fairness. Two recent initiatives in Hong Kong have, however, prompted a reappraisal of the place of portfolios in English language learning. They include the use of learning portfolios in secondary school and ePortfolios by university students for learning and employment purposes.

As an English (L2) teacher of many years, I initiated my research to investigate the experiences of seven university students in Hong Kong in using reflective portfolios for English learning. Three research questions framed my research: 1) in what ways can reflective portfolios impact on L2 learning strategies? 2) what are the effects of reflective portfolios on progress in L2 acquisition as perceived by students? 3) what are the perceptions of university students towards reflective portfolios as a method of L2 learning?

To gain a holistic understanding of the complex phenomena under scrutiny, a case study methodology and grounded theory were utilised, the former to organise and generate qualitative data, and the latter to analyse data from three sources provided by the seven participating students: semi-structured interviews, portfolio artefacts, and weekly learning diaries.

There were two levels of data analysis. For the first level, analysis focused on coded data from portfolio artefacts, diary entries and interview transcripts as reported by students. The second level involved analysis from the Confucian and sociocultural perspectives. I pursued interpretation and continuous refinement of the data by using techniques drawn from grounded theory. The findings revealed that students generally employed a wide spread of L2 learning strategies in the cognitive, meta-cognitive, and socio-affective domain, reported increased awareness of effective language strategies, and considered portfolios a means of supporting time management and record-keeping, and a site for extended writing practice through reflection.

The findings suggest that students display a cyclical, context-specific shift in learning conception from quantitative to qualitative. Connected to this is students’ apparent ability to formulate strategic responses to externally imposed demands. It is found that such responses are culturally triggered, underpinned by Confucian beliefs. Although the Confucian tradition emphasises respect for established authority, the findings point to students’ creative re-configuration of mental schemata to engender change in role enactment and power relations, with the portfolio as a mediating tool of their experiences.

Based on the findings, I argue that my research has addressed the three research questions and contributed to two crucial aspects of L2 learning. The first pertains to the need for a balanced view of individual effort and social context in second language acquisition, corroborating the significant link between context and learner engagement. Another contribution centres on an enhanced understanding of the relationship between portfolios, reflection and L2, where students’ diaries in English and portfolio artefacts enable them to engage in critical reflection and to identify strategies for L2 improvement.

Understanding resilience in same-sex parented families : the work, love, play study

Background: While families headed by same-sex couples have achieved greater public visibility in recent years, there are still many challenges for these families in dealing with legal and community contexts that are not supportive of same-sex relationships. The Work, Love, Play study is a large longitudinal study of same-sex parents. It aims to investigate many facets of family life among this sample and examine how they change over time. The study focuses specifically on two key areas missing from the current literature: factors supporting resilience in same-sex parented families; and health and wellbeing outcomes for same-sex couples who undergo separation, including the negotiation of shared parenting arrangements post-separation. The current paper aims to provide a comprehensive overview of the design and methods of this longitudinal study and discuss its significance.
Methods/Design: The Work, Love, Play study is a mixed design, three wave, longitudinal cohort study of same-sex attracted parents. The sample includes lesbian, gay, bisexual and transgender parents in Australia and New Zealand (including single parents within these categories) caring for any children under the age of 18 years. The study will be conducted over six years from 2008 to 2014. Quantitative data are to be collected via three on-line surveys in 2008, 2010 and 2012 from the cohort of parents recruited in Wave1. Qualitative data will be collected via interviews with purposively selected subsamples in 2012 and 2013. Data collection began in 2008 and 355 respondents to Wave One of the study have agreed to participate in future surveys. Work is currently underway to increase this sample size. The methods and survey instruments are described.
Discussion: This study will make an important contribution to the existing research on same-sex parented families.
Strengths of the study design include the longitudinal method, which will allow understanding of changes over time within internal family relationships and social supports. Further, the mixed method design enables triangulation of qualitative and quantitative data. A broad recruitment strategy has already enabled a large sample size with the inclusion of both gay men and lesbians.

International operations strategy of public sector organisations

Public sector organisations in many countries are internationalising their operations into other countries. This internationalisation frequently follows channels such as aid schemes offered by the country's government. An investigation was conducted to determine whether the four categories of stJ'ategy approach in Miles and Snow's typology could be used to categorise the internationalisation operation strategy approach of Australian public sector organisations. Qualitative data collected from eight Australian public sector organisations determined that a set of nine operations strategy dimensions identified from the literature applied to the internationalisation behaviours of Australian public sector organisations. The data also indicated that Miles and Snow's four categories of strategy could be used to describe the combined international operation strategy behaviours of Australian public sector organisations. In addition, it was found that the international operation strategy behaviours of Australian public sector organisations aligned with at least two (and in one case four) of Miles and Snow's strategy categories. Alignment with two of Miles and Snow's strategy categories was quite commonly identified in other empirical studies of this typology.

A survey of occupational therapists providing services under the Better Access to Mental Health initiative

The Australian government launched the Better Access to Mental Health initiative in 2006, to help more people access psychological therapies. Occupational therapists can register to offer these services, and this survey aimed to investigate their participation within the first 12 months of operation.
Two surveys were conducted with occupational therapists registered to offer Better Access to Mental Health services, at the six and twelve month mark of the initiative. These surveys collected both quantitative and qualitative data. While the demographic profile of occupational therapists remained stable across the surveys, the client population varied over time. Depression and anxiety were the most common conditions treated under this scheme. Occupational therapists reported generally positive attitudes towards the initiative, and did not identify any pressing training needs. However, the current rebate for services was a source of dissatisfaction for many respondents.
This survey has established a baseline for further investigation in this area. The provision and outcomes of this particular initiative needs to be a priority for future research to secure occupational therapy's place in this developing area of practice, thereby providing consumers with greater choice and access to intervention at a primary health level.

A trilogy on discontinuous innovation. Part I : search

In this article we discuss the concept of Discontinuous Innovation (DI) and how it differs from incremental (or steady-state) innovation. We propose a model to conceptualise the different aspects of DI and discuss the complex nature of the DI process through an investigation of previous literature, and propose a sequence of articles roughly following the key components as described in the conceptual model, beginning with aspects of ‘search’. We then describe an on-going multi-national action research program established to investigate DI through the development of learning networks of firms in several European nations and Australia. The research progress to date is outlined and initial results of analysis on both quantitative and qualitative data collected thus far is used to explore how companies go about searching for clues or ideas about potential discontinuous innovations, which may either create competitive advantage for, or threaten the survival of the business. Key outcomes of the research to date include the identification of the most common search strategies within the participating companies and some descriptive analysis on just how these strategies are implemented in targeted firms. Finally we describe the proposed future research program and the two papers to follow completing the planned three part series on Discontinuous Innovation.

Children’s preferences for group musical activities in child care centres : a cross-cultural study

This paper reports on a cross-cultural research study of children’s preferences for group musical activities in child care centres. A total of 228 young children aged 4–5 years in seven child care centres in Hong Kong and in the Adelaide City of South Australia participated in the study. Both qualitative and quantitative data were collected via a mixed method approach. Result showed that dancing/moving was children’s most preferred musical activity in centres. Significant differences were found between children’s cultural contexts and their preferences for three activities: (1) Singing; (2) Listening; and (3) Playing instruments. Qualitative data further revealed the social phenomena of these two cultural contexts which influenced children’s preferences. Implications for the curriculum planning of early childhood music education arising from these findings are discussed.

Exposing young children to music through the production and presentation of music-appreciation television programs

This paper reports on a research study of the effectiveness of a series of music-appreciation activities for young children in Hong Kong. These activities were designed using world music and were presented as part of a local early childhood television program for community interest. One-undred-and-sixty-eight local preschool children (mean age 4.25) and their classroom teachers, from 16 childcare centres or kindergartens, participated in this study. Qualitative data was collected using individual structured interviews with both children and teachers. The data showed that these music-appreciation activities enriched children's musical experiences and teachers' musical repertoires in early childhood settings. Teachers also showed positive preferences to learn the activities using multimedia tools. Implications for the curriculum planning and teacher training of early childhood music education are discussed.

Play and cultural transition

In many countries, early childhood educators have to confront the issue of how to assist immigrant children adapt to life in a new context. For example, in 2007-08, 44 771 children aged 0- 14 years old came to Australia with their familes to start life afresh (Australian Government 2009). Countries need to put into place policies and Practices that minimise the dislocation that immigrant families and their children face. Knowledge of what other countries are doing to educationally support immigrant children can assist professionals to better understand what is sound practice and what should be avoided. This chapter discusses some of the identified immigration issues of a small sample of Chinese children who have PMR parents/caregivers in Hong Kong. This chapter also examines how the
role of play in early childhood settings can help immigrant children adjust to their new teaching and learning context. Seven early childhood teachers and the principal of a local childcare centre were invited to participate in a small scalc study that is reported on in this chapter. Using convenience sampling, interviews were conducted for qualitative data collection.

Maternity care experiences of Asia ethnic minorities in rural Tasmania, Australia : a mixed methods study

When migrating to Australia Asian women bring with them birthing cultural beliefs and practices, many of which are different from the Australian medical and cultural understanding of reproduction. Such cultural differences may result in conflicts between clients and health care providers especially when the migrants have a poor knowledge of English. The research investigates the maternity care experiences of Asian migrants in Tasmania. The barriers that Asian migrants face in accessing maternity care services and the factors that affect their views towards maternity care were also explored. A mix of quantitative and qualitative methods was employed. Ten women from different ethnic minorities were invited to semi-structured interviews. The qualitative data were analysed using grounded theory. Findings from the interviews were utilized to design a survey questionnaire. Of the 150 survey questionnaires posted, 121 questionnaires were returned. Descriptive statistics and Chi-square tests of independence were used to analyse the quantitative data. Asian migrants followed some traditional practices such as having good rest and eating hot food during the postpartum month. However, they tended to adapt or disregard traditional practices that were no longer applicable in the new environment including the practices of not washing or having a shower. Support is vital for women recovering after childbirth to prevent postnatal depression. Two main barriers migrant women face in accessing health care are language and cultural barriers. Country of origin, partner’s ethnicity, religion and length of stay in Australia are factors that shape the migrants’ views and attitudes towards and experience of maternity care. Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers are recommended to improve available maternal care services. The factors that affect migrants’ view on maternity care should be taken into account when providing maternity care for Asian migrant women.

The accuracy of housing forecasting in Australia

Forecasting is an integral part of all business planning, and forecasting the outlook for housing is of interest to many firms in the housing construction sector. This research measures the performance of a number of industry forecasting bodies; this is done to provide users with an indicator of the value of housing forecasting undertaken in Australia. The accuracy of housing commencement forecasts of three Australian organisations – the Housing Industry Association (HIA), the Indicative Planning Council for the Housing Industry (IPC) and BIS-Shrapnel – is examined through the empirical analysis of their published forecasts supplemented by qualitative data in the form of opinions elicited from several industry “experts” employed in these organisations. Forecasting performance was determined by comparing the housing commencement forecast with the actual data collected by the Australian Bureau of Statistics on an ex-post basis. Although the forecasts cover different time periods, the level of accuracy is similar, at around 11-13 per cent for four-quarter-ahead forecasts. In addition, national forecasts are more accurate than forecasts for individual states. This is the first research that has investigated the accuracy of both private and public sector forecasting of housing construction in Australia. This allows users of the information to better understand the performance of various forecasting organisations.

Football's culture of intoxication : implications for health promotion

Objectives: The objective of this is article is to examine some of the strategies and interventions designed to encourage responsible alcohol consumption within Australian Rules football clubs.
Design: Qualitative research was undertaken with fans of four fans of football teams who compete in the South Australian National Football League (SANFL). In total, 93 interviews were conducted with male (80) and female (13) fans across these clubs. Interview data were thematically analysed with the assistance of the NVIVO software package. To elicit additional insight about the social meanings of drinking, researchers visited football games and a range of social functions.
Results: Analysis of the qualitative data suggests that formal interventions implemented by football clubs often prove ineffectual in encouraging responsible alcohol consumption, with more effective strategies aimed at dissuading heavy drinking being operationalized at an informal level by drinkers themselves through a number of ‘everyday’ or ‘lay’ strategies. Such strategies correspond to the broad analytical categories of ‘keeping safe’, ‘minimising damage’ and ‘taking charge’.
Conclusion: This focus on the role of lay strategies in informing health behaviours makes an important contribution to how we understand health promotion initiatives in relation to harmful drinking in sport and other contexts.

How precarious employment affects health and safety at work : the case of temporary agency workers

International studies indicate temporary agency workers are more likely to be injured at work than other types of employees. However explanations for this have been less forthcoming. This paper seeks to begin filling this gap. A study was undertaken in Victoria, Australia, of occupational health and safety (OHS) amongst temporary agency workers drawing upon workers' compensation claim files for injured agency and directly hired workers from 1995-2001, and focus groups of temporary agency workers conducted in 2003. In analyzing the results, use was made of risk factors identified in a model that has been developed to explain how precarious employment affects OHS--the pressure, disorganization and regulatory failure (PDR) model (Quinlan and Bohle, 2004, 2009). Drawing principally on qualitative data, the paper finds that whilst agency workers share common risk factors with other forms of precarious workers, unique characteristics associated with the triangular nature of agency employment heighten their vulnerability further.