The China threat : perceptions, myths and reality

"Since the end of the Cold War, one of the most significant debates in international relations has been the question of whether the rise of China as a major economic, political and military power will be a force for stability or instability in the international system and the East Asian region. Forceful arguments have been put forward on both sides."
"This book examines perceptions of the 'China Threat', and governments' policies in response to the perceived threat in a wide range of countries, including the United States, Russia, Europe, Japan, South Asia, South-East Asia and the Middle East, as well as the perceptions of the Chinese themselves. For each country current security concerns and policies, especially the policy of engagement, are examined in detail, and future prospects for relations with China are assessed. As the Bush administration in Washington increasingly focuses on China as a 'strategic competitor' and Sino-US-relations become increasingly tense, the 'China Threat' issue has come to dominate the security agenda in the Asia-Pacific region, and now poses the biggest foreign policy challenge of the twenty-first century."

The implementation of OECD corporate governance principles in post-crisis Asia

The recent OECD Principles on Corporate Governance provide a framework for the convergence of global corporate governance practice. This paper considers the implementation of these global ‘best-practice’ standards of governance as part of the continuing post-economic-crisis reform throughout Asia. These initiatives have explicitly acknowledged that no single model of governance can exist, and instead have focused on those elements apparently common and, therefore, applicable to all countries. Notwithstanding the existence of these elements, this paper investigates the difficulties involved when attempting to implement general rules across countries at different stages of economic and legal development. While implementation will be hindered by obvious cultural disparities, long-term change in practice requires a cultural shift in the philosophical and financial bases of the firm.

Training general practitioners in flexible sigmoidoscopy to screen for colorectal cancer

Background: A screening programme to detect polyps or early carcinoma would significantly reduce the mortality and morbidity of colorectal cancer (CRC). The aims of the present study were to evaluate: (i) the feasibility of training general practitioners in flexible sigmoidoscopy (FS) for CRC screening; (ii) the acceptability of screening by faecal occult blood testing (FOBT) and FS in asymptomatic standard risk Australians aged over 50 years; and (iii) the yield of such screening. Methods: Subjects were recruited by general practitioner (GP) referral, newspaper advertisement or by a direct approach to retirement villages. Participants were mailed a FOBT kit and a prescreening questionnaire. Flexible sigmoidoscopy was performed by a GP supervised by an experienced endoscopist. Subjects then completed a second questionnaire. General practitioners were assessed after 50 unassisted procedures. Results: A total of 264 individuals contacted the study coordinator; 169 were screened. Screening was accepted well by the participants. Fifteen per cent of subjects had polyps and 4% had a positive FOBT. Training in FS was adversely affected by the availability of resources. Three GPs completed 50 unassisted procedures over a 15-month period, but none were able to reliably assess the distal bowel. Conclusions: Although the three trainees and their supervisors did not consider that the GPs were adequately trained after 50 unassisted procedures, training was adversely affected by limited resources within the Victorian public hospital system. Screening by FOBT and FS was considered to be acceptable by the patients undergoing these procedures. Existing facilities are not adequate if GPs are to be trained in FS as part of a national CRC screening program.

The nature and development of the general insurance industry in Australia to 1973

The development of the insurance industry in Australia in the twentieth century was fundamentally shaped by a collusive code of conduct called the tariff. This arrangement, established to overcome problems of uncertainty, initially benefited both tariff and non-tariff firms by enhancing market stability. It also reduced competition. The collusive agreements gradually broke down, however, as new entrants and products entered the market in the 1950s. Self-regulation gradually gave way as the 'rules of the game' changed. The result was a period of instability before new competitive practices, and more direct and specific regulatory requirements emerged in the 1970s.

HIV discrimination : integrating the results from a six-country situational anaylsis in the Asia Pacific

The findings of the six independent studies on institutional forms of HIV discrimination in the Asia Pacific presented in this Special Issue of AIDS Care are integrated. At first glance, the general pattern of the results across the study sites suggests that discrimination is most pertinent in the domain of 'practice' rather than in the domains of law or institutional policy. On closer analysis, however, utilising the qualitative data, this conclusion does not take sufficient account of the cultural context within which the interpersonal interaction (practice) between the health carers and people living with HIV/AIDS occurs. Limitations on the use of anti-discrimination legislations and protective written policies for reducing discrimination in these contexts are discussed. The need for alternative approaches to thinking about discrimination intervention is raised and this is done through a consideration of the strategy of universal precautions.

Can Australain general practitioners tackle chidhood overweight/obesity? Methods and processes from the LEAP (live, eat, and play) randomized controlled trial

Background: General practitioners (GPs) could make an important contribution to management of childhood overweight. However, there are no efficacy data to support this, and the feasibility of this approach is unknown.

Objectives: To determine if GPs and families can be recruited to a randomized controlled trial (RCT), and if GPs can successfully deliver an intervention to families with overweight/obese 5- to 9-year-old children.

Methods: A convenience sample of 34 GPs from 29 family medical practices attended training sessions on management of childhood overweight. Practice staff trained in child anthropometry conducted a cross-sectional body mass index (BMI) survey of 5- to 9-year-old children attending these practices. The intervention focused on achievable goals in nutrition, physical activity and sedentary behaviour, and was delivered in four solution-focused behaviour change consultations over 12 weeks.

Results: General practitioners were recruited from across the sociodemographic spectrum. All attended at least two of the three education sessions and were retained throughout the trial. Practice staff weighed and measured 2112 children in the BMI survey, of whom 28% were overweight/obese (17.5% overweight, 10.5% obese), with children drawn from all sociodemographic quintiles. Of the eligible overweight/obese children, 163 (40%) were recruited and retained in the LEAP RCT; 96% of intervention families attended at least their first consultation.

Conclusions: Many families are willing to tackle childhood overweight with their GP. In addition, GPs and families can participate successfully in the careful trials that are needed to determine whether an individualized, family-based primary care approach is beneficial, harmful or ineffective.

A review of stock enhancement practices in the inland water fisheries of Asia

Inland fisheries contribute only about ten percent to global fish production. Asia is the leading producer of inland fish, accounting for over 80 percent of the total production. Until recently, the inland fisheries sector had taken back stage in fisheries development plans, particularly so, given the emphasis being placed on aquaculture development throughout the world, including Asia. This report evaluates the inland fishery practices in a number of Asian countries according to habitat type, role in overall foodfish supplies and development trends. Special emphasis is laid on stock enhancement in inland fisheries in Asia, and only those fisheries in which some form of stock enhancement is practised are considered in this report.

In Asia, inland fisheries are mostly rural, artisanal activities catering to rural populations and providing an affordable source of animal protein, employment and household income. Stock enhancement is an integral component of many inland fisheries. With recent developments in
artificial propagation techniques for fast-growing and desirable fish species and the consequent increased availability of seed stock, such activities are beginning to affect inland fishery production in most Asian countries. Indeed, new avenues of production such as culture-based fisheries are increasingly adopted and seen as a way forward in most countries. Inland fishery activities also have a distinct advantage in that their development is usually less resource intensive than is aquaculture.

The economic viability of stock enhancement of large lacustrine waterbodies and rivers has not been demonstrated in any of the Asian countries, the fisheries of such waterbodies being dependent on naturally recruited stocks. The most successful stock enhancements in Asia are in floodplain beels and oxbow lakes in Bangladesh where the use of small waterbodies that are not capable of supporting natural fisheries has led to culture-based fisheries having stock and recapture rates that are very high. Culture-based fisheries are not resource intensive and are community-based activities. However, their success requires major institutional changes, and these are affected by national and local governments. In general, they can be considered to have the greatest potential for further development.

A major concern related to stock enhancements in inland waters is their possible effects on biodiversity. This is for two reasons: firstly, most countries depend wholly or partially on exotic species for stock enhancement and secondly, freshwater fishes are known to be among the most threatened of vertebrates. Major studies should be undertaken to evaluate the current situation so that remedial steps can be taken, if needed, without causing serious harm to some of the stock enhancement practices that are gaining momentum.

Federalism in Asia

Federalism in Asia explores the range of theoretical perspectives that shape debates over federalism in general, and over territorial, multinational, hybrid, and asymmetric federalism in particular relation to Asia. The contributors share their understanding of how federal or quasi-federal institutions manage ethnic conflicts and accommodate differences, how democratization facilitates the development of federalism and how federalism facilitates or inhibits democratization in Asia. Their conclusion is that hybrid federalism or quasi-federalism is more prevalent in some Asian countries than others; and the need and potential for greater federalism in more Asian countries makes this sortie into this area worthwhile.

Post choice satisfaction among international postgraduate students from Asia studying in Victorian universities

As a study destination Australian universities operate in a competitive international market for full fee paying international students. In order to be successful it is vital that universities, like any other business, address issues of customer satisfaction. Using the expectations/perceptions paradigm this study examines the gap between pre-choice expectations and post-choice perceptions and the resulting satisfaction levels of international postgraduate students from four Asian countries studying in Victorian universities. The study concludes that although the students, in general, appear to be relatively satisfied with the university as a study destination, students' perceptions remained far below expectations across all factors and variables investigated. The study also found that there were significant variances in the expectations and perceptions among students from different countries, suggesting that the impact of culture on the decision-making behaviour of students requires further investigation.

Falls prevention in rural general practice: what stands the test of time and where to from here?

Objective: General practitioner recall of the 1992–96 'Stay on Your Feet' (SOYF) program and its influence on practice were surveyed five years post-intervention to gauge sustainability of the SOYF General Practice (GP) component.

Methods: A survey assessed which SOYF components were still in existence, current practice related to falls prevention, and interest in professional development. All general practitioners (GPs) situated within the boundaries of a rural Area Health Service were mailed a survey in late 2001.

Results: Response rate was 66.5% (139/209). Of 117 GPs in practice at the time of SOYF, 80.2% reported having heard of SOYF and 74.4% of those felt it had influenced practice. Half (50.9%) still had a copy of the SOYF GP resource and of those, 58.6% used it at least 'occasionally'. Three-quarters of GPs surveyed (75.2%) checked medications 'most/almost all' of the time with patients over 60 years; 46.7% assessed falls risk factors; 41.3% gave advice; and 22.6% referred to allied health practitioners. GPs indicated a strong interest in falls prevention-related professional development. There was no significant association between use of the SOYF resource package and any of the current falls prevention practices (all χ² >0.05).

Conclusions and implications: There was high recall of SOYF and a general belief that it influenced practice. There was little indication that use of the resource had any lasting influence on GPs' practices. In future, careful thought needs to go into designing a program that has potential to affect long-term change in GPs' falls prevention practice.

Improving the quality of diabetes care in general practice

Objective: The evidence treatment gap for patients with type 2 diabetes.
Design: A summary of convenience sample of seven general practices.
Setting: Metropolitan and rural Victoria, Australia.
Participants: 561 patients of general practices (75% from rural general practices).
Main outcome measures: Demographic data, duration of diabetes, diabetes complications, HbA1c and lipid levels, blood pressure and score on PHQ-9.
Results: Patients with depression show more severe, progressive and intensively treated diabetes. The prevalence of depression in diabetes is about twice that of the general population.
Conclusion: Australian guidelines for diabetes should recommend screening for depression.

Contribution of Australian cardiologists, general practitioners and dietitians to adult cardiac patients’ dietary behavioural change

Aim:  To investigate the use of behavioural change techniques by cardiologists, general practitioners and dietitians in adult cardiac patients within 12 months of their cardiac event.
Method:  Quantitative cross-sectional surveys. Frequency analyses were conducted on the respondents' answers to questionnaire items. Chi-squared test of independence compared responses of the three professional groups on the questionnaire items. Analyses of variance were conducted to explore the impact of the independent variables: age, sex and time worked on the behavioural change techniques used by the respondents.
Results:  The respondents included 248 general practitioners (30% response), 189 cardiologists (47% response) and 180 dietitians (60% response). General practitioners and cardiologists acted mainly as advocates for dietary change in the dietary management process. Dietitians provided nutrition knowledge and a range of techniques to assist dietary behavioural change. Cardiologists and dietitians shared little nutrition information with general practitioners (cardiologists with general practitioners = 8%, dietitians with general practitioners = 49%).
Conclusion:  The present study shows that cardiac patients may have insufficient access to knowledge of nutrition and techniques to assist them with dietary behavioural change.

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.