Human rights and rehabilitation outcomes

Purpose. The aim of this article is to introduce rehabilitation professionals to the rapidly growing literature on human rights particularly as it relates to health and rehabilitation. The article aims to stimulate further discussion and debate concerning the place of human rights in rehabilitation practice.

Method. Some important milestones in the recent history of the human rights movement are briefly outlined, and some important terms in the rights literature are explained. The Ward and Birgden model of the structure of human rights is then described as an example of a rights perspective that might have particular relevance for health and social services and rehabilitation.

Results. A rehabilitation case study is presented as an example of how the Ward and Birgden model could have practical relevance when deciding on the most important outcomes for an individual in rehabilitation.

Conclusion. Human rights are playing an increasing role in the struggle to improve health and healthcare globally. They also have important implications for rehabilitation practitioners and researchers and should form the core of any ethical framework for rehabilitation. It might even be argued that rights and dignity are themselves valued outcomes for rehabilitation.

E-governance as digital ecosystem : a new way to think about citizen engagement and the internet?

There has been a long history of attempting to deploy networked information and communications – mostly in the form of the Internet – to support the broad goals of effective, efficient and responsible democratic government. While there has been considerable talk about the way such technologies might promote better governance – through increased citizen participation in debates and discussions about future outcomes – there has been, in contrast, much action that actually uses the Internet for more efficient government, by creating online and networked interfaces by which citizens can transact business with government. There has been only limited success in using the Internet and similar communications channels to allow citizens to participate in their own governance. Undoubtedly, the Internet does facilitate public consultation. For example, the European Commission used an Interactive Policy Making web tool for public consultation on legislation for regulation of chemicals. Over 6,500 contributions were received over a period of 2 months and the consultation process led to the identification of key flaws in proposals, saving billions of Euros (Timmers,2008). However, consultation of this kind tends to be a mechanism for gathering opinion and gaining citizen approval for change that is not different except in transmission form than previous approaches based on meetings and written submissions. While the European Commission example can be seen as successful, Internet-based consultation can too easily become promotional or marketing oriented, as in recent efforts in Australian by the Federal Communications Minister to use a blog to discuss proposed changes to Internet censorship regulations: in this case, discussion and debate from participants appears largely to have been ignored in favour of a pre-existing position. This paper aims to provide a solution to some of these problems by drawing on the idea of how the Internet can host and support a digital eco-system.

Medication adherence self-report instruments : implications for practice and research

Background: After an acute cardiac event, adhering to recommendations for pharmacologic therapy is important in achieving optimal health outcomes. Considering the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence are less well developed. Furthermore, accessing reliable, valid, and cost-effective mechanisms of monitoring adherence in the research and clinical settings is challenging. Aim: The aim of this article was to review published self-report measures assessing and monitoring medication adherence in cardiovascular disease and provide recommendations for research into medication adherence. Methods: The electronic databases CINAHL, Medline, and Science Direct were searched using the key search terms medication adherence and/or compliance, cardiovascular, self-report measures, and questionnaires. The World Wide Web was searched using the Google and Google Scholar search engines, and reference lists of retrieved documents were reviewed. The search strategy was verified by a health librarian. Instruments were included if they specifically addressed medication adherence as a discrete construct rather than a disease-specific or a generic health status measurement. Findings: Despite of the problems with medication adherence identified in the literature, only 7 instruments met the search criteria. There was limited use of instruments across studies and settings to enable comparison across populations and extensive psychometric evaluation. Conclusions: Medication adherence is a complex, multifaceted construct dependent on a range of physical, social, economic, and psychological considerations. In spite of the importance of adherence in ensuring optimal cardiovascular outcomes, conceptual underpinnings and methods of assessing medication adherence require further discussion and debate.

Ethics education for accounting students - a toolkit approach

In 2006, the International Accounting Education Standards Board (IAESB), an independent standard-setting board of the International Federation of Accountants (IFAC) released an information paper entitled Approaches to the Development and Maintenance of Professional Values, Ethics and Attitudes in Accounting Education Programs. The information paper stems from a global research project on ethics education in the accounting profession. The paper is designed to stimulate discussion and debate on the subject of ethics education and includes the provision of an Ethics Education Toolkit to encourage and assist accounting educators and member bodies of IFAC to implement ethics education programmes. Through a review of the literature, this paper considers why we should teach ethics, the types of ethics interventions that have been undertaken and the issues in teaching ethics to accountancy students. The paper then describes in detail the Ethics Education Toolkit and provides some evidence on the positive reaction of a group of students who are taught ethics, based on the principles and practice included in the toolkit.

Aiming for world peace by promoting 'violence' in education

In order to contribute towards UNESCO’s goal of pursuing world peace, aims of education must transcend the limited scope of national self-interest which has dominated schooling systems in the West for the last two centuries and further back when the survival of each polis in Ancient Greece was of paramount importance. Aims must therefore become different and the environment that is thought best for this to occur is a democratic one. The case is made that such a democratic environment should involve opportunities to evaluate the value of current aims of education and to explore others in light of the pressing need to pursue peace on a global scale. In order to promote such a democratic environment of discussion and debate the notion of ‘violence’ is considered as a potential framework for such a re-evaluation. The sort of ‘violence’ that is called for is in reference to its use by Emmanual Levinas who employed it emotively to misinterpret Kierkegaard. The use of this misapplied term ‘violence’ may nevertheless be of use in initiating the sort of inquiry of a Deweyean type regarded here to be necessary to improve aims of education democratically in order to pursue world peace.

The HWMD maturity model: a foundational framework to measure effectiveness of institutional research e-infrastructures

There is a nationally recognised need for a framework and tools to measure progress in implementing e-infrastructures for research from an institutional, organisational unit and service perspective. This paper describes the development of a prototype maturity model and self-assessment tool in response to that need. The authors present a background to the environment of technology enabling services for research and the challenges of fluidity of boundaries around traditional services and roles as institutions respond to the needs of the research community. The conceptual basis of the model is presented along with the model and its various elements that explain how the model is in its current form. The information provided in this paper, combined with field site test feedback, will promote discussion and debate amongst the community and opportunities will present to gather input to optimise the model. The next steps would be to further elaborate and test the constructs and indicators of the model in field test sites and to further develop the self -assessment tool.

Community participation in HIA: discords in teleology and terminology

Core HIA documents, researchers and practitioners assert the significance of community participation in health impact assessment. Despite the rhetoric, there has been little critical examination of the role of community participation in HIA. Knowledge and debate regarding what constitutes community participation and how it may best be achieved is often confused and opinion is divided as to its usefulness and appropriateness for HIA. This paper does not seek to argue the merits or drawbacks of community participation; rather, the authors explore the origins and character of the current discord around public participation in HIA and provide a lexicon for moving practice and discussion forward. The authors argue that the origins of the participation problem stem from: (1) unexplored tensions within the Gothenburg consensus paper and other formative documents in the development of HIA; (2) inherent tensions arising from the dual origins of HIA, specifically Environmental Impact Assessment (EIA) and Healthy Public Policy (HPP); and (3) a lack of rigour and clarity relating to the terminology of community participation where community participation is used as a 'catch all' phrase for every situation without critical examination. In order to move debate forward, the authors advance a model, the Typology of Public Involvement in HIA, for guiding discussion of community participation. This model comprises a set of context-specific HIA approaches with varying degrees of public involvement. The model also presents a suite of defined terms for understanding and discussing participation.

Psychological and interpersonal dimensions of sexual function and dysfunction

Introduction. There are limited outcome data on the etiology and efficacy of psychological interventions for male and female sexual dysfunction as well as the role of innovative combined treatment paradigms.
Aim. This study aimed to highlight the salient psychological and interpersonal issues contributing to sexual health and dysfunction, to offer an etiological model for understanding the evolution and maintenance of sexual symptoms, and to offer recommendations for clinical management and research.
Methods. This study reviewed the current literature on the psychological and interpersonal issues contributing to male and female sexual dysfunction.
Main Outcome Measure. This study provides expert opinion based on a comprehensive review of the medical and psychological literature, widespread internal committee discussion, public presentation, and debate.
Results. Medical and psychological therapies for sexual dysfunctions should address the intricate biopsychosocial influences of the patient, the partner, and the couple. The biopsychosocial model provides an integrated paradigm for understanding and treating sexual dysfunction.
Conclusions. There is need for collaboration between healthcare practitioners from different disciplines in the evaluation, treatment, and education issues surrounding sexual dysfunction. In many cases, neither psychotherapy alone nor medical intervention alone is sufficient for the lasting resolution of sexual problems. The assessment of male, female, and couples’ sexual dysfunction should ideally include inquiry about predisposing, precipitating, maintaining, and contextual factors. Research is needed to identify efficacious combined and/or integrated treatments for sexual dysfunction.

Blue sky thinking : using projective techniques to stimulate discussion, reflection and insight

The prime purpose of this session is to share a new use of projective techniques to stimulate discussion, reflection and insight with students. The session will provide an introduction to the nature and use of projective techniques and an explanation why images of the sky were chosen as the stimuli. Then, the majority of the session will consist of an opportunity to experience this new technique in a simulated session. The session will end with a plenary discussion and a review of the effectiveness and applicability of the technique.

CFL bulbs : environmentally friendly and sustainable?

The purpose of this paper is to document the positive and negative characteristics of using compact fluorescent lamps (CFL) and to raise awareness and debate about the potential negative health effects resulting from prolonged exposure to CFLs. This is a theoretical paper and, primarily, incorporates the literature and the author’s experiences of CFLs. Governmental and non-governmental measures in the area of recycling and disposal of CFLs are also presented. This is a relatively new area of research; hence, very limited academic literature is currently available. Discussion of the issue of increased usage of CFLs is timely following heightened debate on greenhouse gas emissions and climate change. Increased debate amongst the policy and decision-makers will assist the public to make an informed decision. It is also anticipated that this debate will put pressure on the manufacturers of all types of bulbs, and government and non-governmental agencies to enhance their own and community initiatives to recycle and/or safely dispose of CFLs. No other similar review of the advantages and weaknesses of using CFLs has been undertaken that encourages the reader and potential users of CFLs to reflect on their choices.

‘It would be okay if they came through the proper channels’: community perceptions and attitudes toward asylum seekers in Australia

Australia's humanitarian programme contributes to UNHCR's global resettlement programme and enhances Australia's international humanitarian reputation. However, as the recent tragedy on Christmas Island has shown, the arrival of asylum seekers by boat continues to stimulate debate, discussion and reaction from the Australian public and the Australian media. In this study, we used a mixed methods community survey to understand community perceptions and attitudes relating to asylum seekers. We found that while personal contact with asylum seekers was important when forming opinions about this group of immigrants, for the majority of respondents, attitudes and opinions towards asylum seekers were more influenced by the interplay between traditional Australian values and norms, the way that these norms appeared to be threatened by asylum seekers, and the way that these threats were reinforced both in media and political rhetoric.

Nation-building across the urban and rural in Timor-Leste : conference report

‘Nation-building across Urban and Rural Timor-Leste’ provided an opportunity for East Timorese and people from around the world to reflect, discuss and debate the nation-building process in Timor-Leste since 1999. In this context, nation-building in Timor-Leste is taken to mean the many different attempts since 1999 to ensure the political, economic and cultural integration of the population to fulfil the ambition of self rule.

Ten years after the 1999 vote for independence, this conference considered how nation-building is being experienced and responded to across urban and rural communities in Timor-Leste. Broadening the discussion beyond that of ‘state-building’, at the core of the conference was a consideration of the myriad ways the new republic has been ‘built’. Here ‘nation-building’ considers not only in terms of policy and programmatic initiatives but also grass roots experiences and perceptions of how Timor-Leste as a nation is seen and understood. For this reason, the majority of participants were East Timorese representatives from across the districts, allowing them top share their stories of nation-building.

A tale of two Victorian historic coastal towns : dilemmas of planning and conservation in Queenscliff and Sorrento

Change has engulfed the coastal fringe of Australia. In balancing the built and natural environment, community needs, cultural significance and economic sustainability, planners aim to improve quality of life and create vibrant communities. Yet managing place change, particularly in coastal areas, is fraught with tensions. Most planning discussions about the rapidity of change, the impact of the Sea Change process and increased development have focused upon the extensiveness of residential expansion and the housing styles that challenge the essence of the character of these coastal towns. Character and sense of place qualities are the very reasons that sea changers desire to engage with and reside within these communities. One aspect missing from this discussion and analysis is the impact that large-scale transformations of iconic buildings are having upon these places. This paper examines the consequences that major commercial development projects have upon the communities of Sorrento and Queenscliff. It considers changes (proposed or realised) to four landmark historic hotels: The Koonya and Continental in Sorrento; and the Ozone and Vue Grand in Queenscliff. This paper focuses on issues of planning, social engagement and community debate.