Multidisciplinary research perspectives in education shared experiences from Australia and China

The editors of this extraordinary book, Indika Liyanage and Badeng Nima, have brought together a wonderfully wide-ranging collection of chapters. The breadth and depth of the studies of education issues in China and Australia are impressive. The topics encompass important questions concerning education policies, curricula, pedagogy, equality, parental engagement, cultural heritage, and anti-drug education. The scope of the book includes Chinese and Australian settings that range from kindergartens to higher education, and from rural to urban environments. The diversity of the book strengthens rather than weakens its coherence, because the golden thread running through all the chapters is a portrayal of the complexity of education provision when global, national and local forces interact. Written by academics with hands-on experience, the chapters provide evidence-based discussions of practical conundrums, enriched by the sophisticated use of interdisciplinary approaches. As a result, this book is powerful, challenging and ground-breaking.

Covert dose reduction is a distinct type of medication non-adherence observed across all care settings in inflammatory bowel disease.

BACKGROUND: Non-adherence by dose omission is common and deleterious to outcomes in Inflammatory Bowel Disease (IBD), but covert dose reduction (CDR) remains unexplored. AIMS: To determine frequency and attitudinal predictors of overall medication non-adherence and of covert dose reduction as separate entities. METHODS: A cross sectional questionnaire was undertaken involving IBD patients in three different geographical regions and care settings. Demographics, medication adherence by dose omission, and rate of patient initiated dose reduction of conventional meds without practitioner knowledge (CDR) were assessed, along with attitudes toward IBD medication. RESULTS: Of 473 respondents (mean age 50.3 years, 60.2% female) frequency of non-adherence was 21.9%, and CDR 26.9% (p<0.001). By logistic regression, significant independent predictors of non-adherence were dissatisfaction with the patient-doctor relationship (p<0.001), depression (p=0.001), anxiety (p=0.047), and negative views regarding medication efficacy (p<0.001) or safety (p=0.017). Independent predictors of covert dose reduction included regular complementary medicine (CAM) use (p<0.001), experiencing more informative (p<0.001) and comfortable (p=0.006) consultations with alternative practitioners, disbelieving doctor delivered information (p=0.021) and safety concerns regarding conventional medication (p<0.001). Neither the frequency of non-adherence (p=0.569) nor CDR (p=0.914) differed between cohorts by different treatment settings. CONCLUSIONS: Covert dose reduction of IBD medication is more common than omission of medication doses, predicted by different factors to usual non-adherence, and has not been previously reported in IBD. The strongest predictor of CDR is regular CAM use.

Peri-gondwanan permian correlations : the meso-tethyan margins

Correlations of the Permian sequences for sixteen regions of north eastern Gondwana during the Permian are presented in this review. These correlations are compared with Permian sequences of the Australian continent. Broad conclusions on palaeoclimatic change and tectonic events are summarised for six time intervals of the Permian Period.

The Asselian-Sakmarian-early Artinskian time interval indicates a change from cold to temperate depositional environments. Glacial deposits and low diversity Gondwanan marine faunas are succeeded by younger, warmer water, clastic and bioclastic sequences with moderately diverse marine faunas. Deposition of these sequences is occasionally associated with basaltic volcanism and initial rifting of the peripheral northern Gondwanan margin.

During the Late Artinskian-Kungurian (including Early Ufimian) time interval, climate amelioration occurred with the onset of carbonate deposition in several Cimmerian terranes. Basaltic volcanism in several terranes is indicative of significant rifting and the opening of the Meso-Tethys.

The Roadian (Late Ufimian) and Wordian-Capitanian (including Kazanian-Midian) time intervals were characterised by widespread, subtropical, marine carbonate depositional sequences. These occurred throughout the Cimmerian blocks as they drifted northward and on the more northerly parts of the Meso-Tethyan southern margin. These transgressive sequences may rest on significant unconformity surfaces. Equivalent carbonate units are known in the offshore and subsurface sequences of western Australia. Andesitic, convergent plate margin volcanism and volcaniclastic sequences are present in eastern Australia.

The Wuchiapingian time slice is characterised by widespread marine transgressions which extended into the north western basins of Australia.

The Changhsingian time slice is represented by relatively minor marine transgressive events in the Trans-Himalaya with the Selong section of Tibet being probably the most complete Permo-Triassic sequence for the southern margin of the Meso-Tethys.

Recovery after stroke : a qualitative perspective

The purpose of this study was to determine the impact of stroke on survivors of the condition and to identify their physical and psychosocial needs in rural and regional settings. Data were collected via focus group interviews with stroke survivors, carers and key informants. Data were managed using NUD*IST and analysed using a content analysis method identifying major themes related to the impact of living in the community after having a stroke. It was found that stroke survivors suffered severe physical and emotional effects. The findings also identified the vulnerability of this group and a lack of organised, on-going psychosocial and rehabilitative support. Recommendations are made to enhance the current management of stroke after the acute and subacute phases.

Straddling the pathway from paediatrician to mainstream health care : transition issues experienced in disability care

Objective: To identify the strengths and limitations of health care and related services provided to young adults with a disability during the period of transition from the care of a paediatrician to the mainstream health system.
Design: A descriptive design was used to address the study objectives.
Setting: Barwon and south-western region of Victoria.
Subjects: Twelve focus group discussions, with young adults with a disability, carers of young adults with a disability and health care service providers. Each focus group involved eight to 10 participants.
Results: The findings revealed a number of problems with the transition period. All participants acknowledged the supportive, coordinating role of the paediatrician. In the absence of this type of role, carers felt they lacked the knowledge and support to manage the adolescent with a disability. Communication problems between all service providers were identified as being problematical. The general lack of continuity of care between providers made it difficult for individuals to negotiate the transition period and increased the burden of care on carers.
Conclusion: There is a need for policy makers to address these transition problems and develop appropriate services that improve the situation for young adults with a disability and their carers.
What is already known: It is well documented that the transition period from paediatrician to adult health care services is problematic for the young adult with a disability and their carer. The difficulties experienced are attributed to poor communication between service providers and a lack of continuity of care.
What does this study add: This study provides insights from a number of different consumer and health care professionals' perspectives. The findings identify service delivery gaps and a need to develop health care services that could assist the young adult with the disability negotiate this transition from the paediatric services to mainstream health care services in rural and regional settings in Victoria.

Faster, richer, better: rapid appraisal techniques for the study of IS implementation in virtual communities

A major issue in Information Systems (IS) research is how to combine relevance and rigor (Benbasat and Zmud, 1999) and reduce the widening gap between research results and adoption (Dunn, 1994). Qualitative researchers make use of interpretivist methods to add richness and depth to their understanding of user problems. Interpretivist methods applied to IS implementations can thus result in research which communicates those findings more effectively. However standard interpretivist data-collection and analysis methods can be time-consuming and expensive. Findings based on these methods may be irrelevant to practitioners by the time they reach publication stage. A potential solution to this problem lies in Rapid Appraisal or RA, a qualitative appraisal methodology derived from rural development-related research. It offers IS researchers an additional technique for learning and acquiring relevant information in a limited period of time that  supplements current data collection and analysis techniques. RA adds value to the traditional approach for studying diffusion of innovation, supporting and extending the IS researcher’s qualitative ‘tool-kit’. In this paper we review an electronic gateway designed to facilitate the diffusion of an Australian government to business [G2B] export documentation system, EXDOC, which was first implemented with meat producers. RA techniques were used to collect and analyse data regarding the implementation of the first regional Electronic Trade Facilitation Center [ETFC] successfully established for Australian exporters in the horticulture sector. The findings from the original EXDOC implementation in the meat sector were confirmed and extended through this study. These include the importance of developing a governance structure that ensures all community members share the benefits of an implementation and the fact that virtual trading communities are attractive to users only if they add value to their business and extend standard ways of operating. Interactive interviews, part of the RA approach; also enabled us to expand our understanding of the way in which procedures developed in the course of implementing an electronic market represent value-adding opportunities for virtual trading communities. The paper has special relevance for researchers investigating adoption and diffusion issues experienced by small-scale producers with low exposure to technology in remote and rural settings.

Does a continence educational brochure promote health-seeking behavior?

OBJECTIVE: This study reviewed whether participants who were given a continence education package, which included a Continence Educational Brochure (CEB), and who indicated that they were bothered by incontinence symptoms changed health-seeking behaviors about their incontinence problem because of being given the brochure.
METHOD: This study used a descriptive and exploratory design. Participants were given the CEB and asked to read the information. They were also asked to complete a continence questionnaire and mail this back to the research team. Participants who indicated that they were bothered by a continence problem and consented to being interviewed were telephoned 2 to 3 months later. They were asked questions to determine their actions and progress in relation to managing their continence problem and whether the CEB had influenced their behavior.
SETTING AND SUBJECT: A total of 631 participants (352 females, 55.8%; 279 males, 44.2%) from 4 rural and regional settings in Victoria, Australia, participated. Of this sample, 111 participants (78 females, 70.3%; 33 males, 29.7%) who reported that they were bothered by a continence problem were interviewed 3 months after being given the CEB.
RESULTS: Two thirds of the total sample of participants (n = 111) sought help for their continence problem. Approximately 70.3% (n = 78) continued to have a continence problem. Of this group, 84.6% were still bothered by the continence problem and 65.4% had taken action to treat their incontinence. Forty-nine participants (44.1%) indicated that they had discussed the issue of bladder or bowel problems with someone directly because of this study or the information contained in the brochure. More than 94% of participants who remembered the CEB indicated that they believed the brochure would be helpful if given to other people.
CONCLUSIONS: These findings suggest that the CEB prompted individuals to discuss their continence problem and in fewer cases to seek professional help. Given these findings, distribution of a continence education package is advocated as a continence health promotion strategy.

To post or not to post : undergraduate student perceptions about participating in online discussions

Computer mediated conferencing (CMC) is now a common feature of blended learning environments where students learn in both face to face and online settings. While many teachers recognize the value of online discussions for learning, students appear to have different perspectives. Consequently, their participation in online discussions is often sporadic and not genuinely interactive. This paper examines these issues and provides student perspectives about participation in online discussions which arose from a case study in a conceptually difficult subject. Systems data indicated low numbers of posted messages. Student interviews provide some insights into this lack of participation, and identify the influence of the curriculum design, especially the nature of the learning activity, and its connection to other aspects of the course, for example, assessment and the regular class sessions. Other influential factors include the student’s ideas about learning, managing demands on their time and their acceptance of CMC. The paper also provides recommendations for improving participation in online discussions.

A simplified stroke rehabilitation assessment of movement instrument

Background and Purpose. An efficient, reliable, and valid instrument for assessing motor function in patients with stroke is needed by both clinicians and researchers. To improve administration efficiency, we applied the multidimensional Rasch model to the 30-item, 3-subscale Stroke Rehabilitation Assessment of Movement (STREAM) instrument to produce a concise, reliable, and valid instrument (simplified STREAM [S-STREAM]) for measuring motor function in patients with stroke. Subjects and Methods. The STREAM (consisting of 3 subscales: upper-limb movements, lower-limb movements, and mobility) was administered to 351 subjects with first stroke occurrence and a median time after stroke of 19.5 months. The unidimensionality of each subscale of the STREAM first was verified with unidimensional Rasch analysis. Each subscale of the STREAM then was simplified by deleting redundant items on the basis of expert opinion and the results of the Rasch analysis. The Rasch reliability of the S-STREAM and the concurrent validity of the S-STREAM with the STREAM were examined with multidimensional Rasch analysis and the intraclass correlation coefficient (ICC), respectively. Results. After deleting the items that did not fit the Rasch model, we found that the 8-item upper-limb movement subscale, the 9-item lower-limb movement subscale, and the 10-item mobility subscale assessed single, unidimensional upper-limb movements, lower-limb movements, and mobility, respectively. We selected 5 items from each subscale to construct the S-STREAM and found that the reliability of each subscale of the resulting simplified instrument was high (Rasch reliability coefficients of [greater than or equal to] .91). The agreement between the subscale scores (Rasch estimates) of the S-STREAM and those of the STREAM was excellent (ICC of [greater than or equal to] .99, with a lower limit for the 95% confidence interval of [greater than or equal to] .985), indicating good concurrent validity of the S-STREAM with the STREAM. Discussion and Conclusion. The S-STREAM demonstrates high Rasch reliability, unidimensionality, and concurrent validity with the STREAM in patients with stroke. Furthermore, the S-STREAM is efficient to administer, as it consists of only half the number of items in the original STREAM. Additional studies to examine other psychometric properties (eg, predictive validity and responsiveness) of the S-STREAM or its psychometric properties in various recovery stages after stroke are needed to further establish its utility in both clinical and research settings.

Equity-focused health impact assessment framework

Background to the Development of the Equity-Focused HIA Framework
The equity focused health impact assessment (EFHIA) framework arises out of a two year research project funded for the most part by the Australian Government’s Public Health Education Research Program (PHERP) Innovations Grants (Round 2) scheme. This project had as its primary objective the development of a framework for health inequalities impact assessment, subsequently renamed equity focused health impact assessment. A partnership between the University of Newcastle, Deakin University and the University of New South Wales (the Project Management Steering Committee) received the funding and the Australasian Collaboration for Health Equity Impact Assessment (ACHEIA) was formed to undertake appropriate background research and to develop, pilot test, modify and disseminate the framework. The work commenced in September 2002 and concluded in October 2004. Part of the funding included a capacity building workshop in August 2004. ACT Health and the Division of Medicine at the John Hunter Hospital, Newcastle, also provided financial support for the project. The August 2004 Workshop was supported by NSW Health. All participants and organisations involved in the project gave extensive in-kind support.
The aims of the workshop were to bring together an international collaboration of multidisciplinary investigators, public health experts, and key senior health managers working in national, state and local settings, to inform the further development of the framework and to provide training in its application. The initial goals of the project were to work collaboratively to develop a strategic framework to assess the health inequalities of public health-related policies, plans, strategies, decisions, programs and services. The EFHIA framework as presented at the August workshop was developed through:
1. an extensive review of the relevant literature
2. formal and informal consultation with members of ACHEIA (the international
reference group), members of the Project Management Steering Committee and
other relevant experts; and
3. testing of the draft EFHIA framework with the 5 case study partners – who applied the draft framework in a range of health settings (see
Acknowledgements).
The result of this work has been the development of an equity focused health impact assessment framework that can be used to determine the unanticipated and systemic health inequities that may exist within the decision making processes or activities of a range of organisations and sectors. The EFHIA framework provides one approach that can be used to assist decision makers to put equity and health on their agenda in a more obvious and systematic way. The framework represents a ‘moment in time’ rather than a definitive statement or ‘toolkit’ on the best way to proceed. Further practice, refinement and adjustment will be needed over many years to consolidate both HIA and EFHIA. As well as this guide to the framework, additional outputs from the project team include:
- A literature review
- A position paper
- A report on the five case studies
- An evaluation report.
With the consent of the Australian Government, a monograph will be made available to workshop participants at the end of October which contains the framework and the appropriate background papers.

A holistic model of corporate governance - a new research framework

Purpose – The purpose of this paper is to propose a new model of corporate governance that is holistic – incorporating internal and macro perspectives across legal, regulatory, sociological, ethical, human resource management, behavioural and corporate strategic frameworks. Researchers have signalled the need for “new theoretical perspectives and new models of governance” due to a dearth of research that is context-driven, empirical, and encapsulating the full spectrum of reasons and actions contributing to corporate crises.

Design/methodology/approach – The approach consists of theory building by reviewing the literature and examining the gaps and limitations.

Findings – The proposed model is a distinctive contribution to theory and practice in three ways. First, it integrates the firm-specific, micro factors with the country-specific, macro factors to illustrate the holistic nature of corporate governance. Second, shareholders and stakeholders are shown to be only one component of the model. Third, it veers away from singular approaches, to dealing with corporate governance using a multi-disciplinary perspective. The paper argues that such a holistic and integrated view is a necessity for understanding governance systems.

Research limitations/implications – The challenge is to operationalize the model and test it empirically.

Practical implications – The model is instructive and of use for practitioners in attempting to understand, explain and develop governance models that are appropriate to their national and industry settings.

Originality/value – This paper argues that narrow-based models are limited in their approach and in a sound and integrative review of the up-to-date literature contributes to theory-building on corporate governance.

Scale matters : the need for a Bipolar Depression Rating Scale (BDRS)

Objective: To briefly review the clinical and biological distinctions between unipolar and bipolar depression critiquing in particular currently available depression rating scales and discuss the need for a new observer-rated scale tailored to bipolar depression.

Method: Relevant literature pertaining to the symptomatic differences between bipolar disorder and unipolar disorder as well as their measurement using existing assessment scales was identified by computerized searches and reviews of scientific journals known to the authors.

Results: Bipolar depression is distinct from unipolar depression in terms of phenomenology and clinical characteristics. These distinguishing features can be used to identify bipolarity in patients that present with recurrent depressive episodes. This is important because current self-report and observer-rated scales are optimized for unipolar depression, and hence limited in their ability to accurately assess bipolar depression.

Conclusion: The development of a specific bipolar depression rating scale will improve the assessment of bipolar depression in both research and clinical settings and assist the development of better treatments and interventions.

Educating for the future : technological advantages?

Educating students for the future involves providing them with skills to cope with technological change. Schools and teachers have been adapting their practices in mathematics and science to incorporate information and communication technology (ICT) as a routine aspect of learning. However, recent research indicates that not all students have equal access to the technologies they need. A number of reasons are investigated: the location of the schools (regional and rural settings), the capabilities of the teachers and access by staff and students to high quality resources. This paper presents the findings of this research.

How do teachers investigate scientific concepts in an Early Childhood Environment?

Early Childhood Educators have an important role to fulfil in aiding children's development and understandings in the science curriculum. There are many different views and opinions on how science can be taught in an Early Childhood environment, it is therefore our aim to investigate how teachers feel about teaching science concepts and promoting science in the early childhood centre. We aim to discover how everyday activities relate to the nature of science within our everyday lives. The science curriculum is important in Early Childhood settings as it provides children with various opportunities to explore the natural world. We are hoping to gain a deeper understanding of how teachers are guiding and encouraging children to make sense of their experiences. It is also important that we explore how Early Childhood Educators understand their own practice in teaching science concepts in their curriculum.

Description of project: We will be completing a small inquiry based task which will require us to compile data collected from interviews, recordings from teachers in long day and kindergarten settings around the Geelong region.

Methodology: ln order to undertake this research we will be using a socio cultural framework, focusing on language in the social environment and play (basing our ideas on the theories of Vygotsky). We will be undertaking narrative accounts to obtain data which will be collated from three different sources.

Ethical implications of projects: We do not foresee any significant risks to any participant in this study. The topic of the research is uncontroversial, and we will be taking measures to ensure anonymity or confidentiality where appropriate.

Reducing obesity in early childhood : results from romp & chomp, an Australian community-wide intervention program

Background: There is growing evidence that community-based interventions can reduce childhood obesity in older children.
Objective: We aimed to determine the effectiveness of the Romp & Chomp intervention in reducing obesity and promoting healthy eating and active play in children aged 0–5 y.
Design: Romp & Chomp was a community-wide, multisetting, multistrategy intervention conducted in Australia from 2004 to 2008. The intervention occurred in a large regional city (Geelong) with a target group of 12,000 children and focused on community capacity building and environmental (political, sociocultural, and physical) changes to increase healthy eating and active play in early-childhood care and educational settings. The evaluation was repeat cross-sectional with a quasiexperimental design and comparison sample. Main outcome measures were body mass index (BMI), standardized BMI (zBMI; according to the Centers for Disease Control and Prevention 2000 reference charts), and prevalence of overweight/obesity and obesity-related behaviors in children aged 2 and 3.5 y.
Results: After the intervention there was a significantly lower mean weight, BMI, and zBMI in the 3.5-y-old subsample and a significantly lower prevalence of overweight/obesity in both the 2- and 3.5-y-old subsamples (by 2.5 and 3.4 percentage points, respectively) than in the comparison sample (a difference of 0.7 percentage points; P < 0.05) compared with baseline values. Intervention child-behavioral data showed a significantly lower intake of packaged snacks (by 0.23 serving), fruit juice (0.52 serving), and cordial (0.43 serving) than that in the comparison sample (all P < 0.05).
Conclusion: A community-wide multisetting, multistrategy intervention in early-childhood settings can reduce childhood obesity and improve young children's diets. This trial was registered with the Australian Clinical Trials Registry at anzctr.org.au as ACTRN12607000374460.