The impact of knowledge and attitudes on access to eye-care services in Cambodia

Purpose: To investigate how knowledge and attitudes influence the access to eye-care services in Takeo Province, Cambodia.

Design: A cross-sectional survey (n=600).

Methods: 30 villages were randomly selected. Groups included: >50 years, 30–49 years, and parents with children <5 years. A newly developed Knowledge, Attitude and Practice in Eye Health (KAP-EH) questionnaire about knowledge and treatment of eye diseases, practices and attitudes to accessing services was used to interview respondents. Descriptive analysis, including Chi square and logistic regression tested for associations with sub-groups of gender, age group, education and self-reported type of disability.

Results: The proportion of respondents who reported having knowledge of specific eye conditions ranged from 97% for eye injury, to 8% for diabetic eye disease. While 509 (85%) people reported knowledge of cataract, 47% did not know how cataract was treated and only 19% listed surgery. The older group (66.5%) were least informed about cataract (p= 0.001) compared to other groups, and were least likely to believe that some blindness could be prevented (p < 0.001). Women (55%) were more likely than men (46%) (p=0 .003) to report that a child with blindness could attend school, as did people without a disability compared to those with a disability (58% vs 34%) (p < 0.001).

Conclusions: The knowledge about cataract and refractive error and what to do to resolve the problems was low among this population and this study suggests that poor knowledge of eye diseases might contribute to the occurrence of un-operated cataract and uncorrected refractive error.

The National Perinatal Depression Initiative: An evaluation of access to general practitioners, psychologists and psychiatrists through the Medicare Benefits Schedule

OBJECTIVE: To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness. METHOD: Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative. RESULTS: The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities. CONCLUSION: In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new mental health policy initiatives incorporate a planned strategic approach to evaluation, which includes sufficient follow-up to assess the impact of public health strategies.

Adaptation to mandated restrictions on smoking in dining areas : results of an Internet survey

Objective : The study aimed to measure changes in dining behaviour associated with the introduction of smoking restrictions on July 1, 2001, to describe strategies adopted by smokers and non-smokers to adapt to the changes, and to describe some of the thoughts, feelings and beliefs underlying the adaptations that people make in response to the introduction of new restrictions.

Method : Data were collected in a longitudinal study with repeated measures of a total of 257 respondents before and after the introduction of the restrictions, using a questionnaire administered via the Internet. Data collection occurred on seven occasions between April 2001 and March 2002. In addition, a series of in-depth telephone interviews was conducted among a group of 31 smokers and non-smokers, who were interviewed once before and twice after the introduction of the bans.

Results : Dining patterns, dining frequency, restaurant choice and expenditure on a meal did not change among either smoking or non-smoking patrons following the introduction of the law. The majority of Victorians approved of smokefree dining legislation before its implementation, and agreement with the law increased sharply and significantly among both smokers and non-smokers immediately following the introduction of the policy, remaining at high levels for the duration of the study period.

Conclusions : These findings suggest there was rapid adaptation to and acceptance of the restrictions among both smokers and non-smokers, and are supported by evidence from other jurisdictions, both interstate and internationally, regarding the introduction of smokefree dining.

An analysis of computer-mediated marketing education : the relationship between access to WEBCT, tutorial attendance and student grades

One of the problems faced by Australian academics in the 21 st century is to facilitate learning with a changing profile of students, in bigger and bigger classes. As educators at tertiary institutions, our environment is undergoing major changes as increasingly marketing programs are offering courses either partially (Web enabled) or totally (Web exclusive) online. This study has developed a significant model allowing the prediction of students' overall results and indicates that a student's final grade is dependant, in part, on accessing the study materials and study tools available to them via WebCT and attending face-to-face tutorials.

OWDEAH: Online Web Data Extraction based on Access History

Web data extraction systems are the kernel of information mediators between users and heterogeneous Web data resources. How to extract structured data from semi-structured documents has been a problem of active research. Supervised and unsupervised methods have been devised to learn extraction rules from training sets. However, trying to prepare training sets (especially to annotate them for supervised methods), is very time-consuming. We propose a framework for Web data extraction, which logged usersrsquo access history and exploit them to assist automatic training set generation. We cluster accessed Web documents according to their structural details; define criteria to measure the importance of sub-structures; and then generate extraction rules. We also propose a method to adjust the rules according to historical data. Our experiments confirm the viability of our proposal.

Access to a healthy diet and fast foods in the City of Casey

It is known that the consumption of fast food is associated with obesity (Binkley 2000). Relative ease of access to fast foods compared with healthy foods may contribute to the increasing prevalence of obesity. The aim of this study was to determine and compare the access by car to fast foods and a healthy diet. The study was located in the City of Casey, a municipality in South East Melbourne with a population of 220,000. We have previously shown that ease of access to a large chain supermarket ensures access to a basket of healthy foods adequate to meet the nutritional needs of a family of 6 (Burns 2004). The City of Casey council provided location details for major fast food outlets and supermarkets. Fast food was defined as food sourced from an outlet without table service. We included only those major fast food chain outlets which had more than 10 franchises within Australia. We included the 3 major supermarket chains that account for 87% total food retailing in Victoria. Geographic details from the City of Casey were used to map the location of these outlets. Then using these locations and road network a basic cost distance model was created for either the supermarket chains or fast food chains outlets. The cost unit is (time), it was to calculate by giving the roads in the network an average travel speed depending in the type of road (minor, major or highway) and then calculating how long it would take to reach the closest outlet. Access to supermarket and fast food outlets were determined relative to population density.
Our results indicate that in the City of Casey most (> 80%) people live within an 8-10 minute car journey of a major supermarket and a fast food outlet. Fifty percent of the fast food outlets are co-located with a supermarket. We conclude that access to both healthy food and fast food in the City of Casey is good if you own a car. The increasing demand for fast food is easily met in this municipality. Obesity prevention strategies in Casey should concentrate on the food choices available at fast food outlets and town planning to ensure a mix of food outlets to maximize the likelihood of healthy food choices.

Building collaborative partnerships: a key to increasing Indigenous Victorian peoples' access to country

This article reports on a qualitative research study undertaken with Indigenous government employees to explore ways in which Indigenous communities can access programs involving caring for Country' (knowledge, responsibility and inherent right to protect the traditional natural landscape) on their traditional land and, in so doing. improve their health. Factors that optimise such nature-based projects are the capacity of their intention to build relationships, consultation. transparency, consistency, education and training between Indigenous communities. government and the general public. Government agencies need to develop strategies where partnership and collaboration are effective with Indigenous communities and within the agencies themselves, in order to resolve controversial issues surrounding access to Country.

Fast food purchasing and access to fast food restaurants : a multilevel analysis of VicLANES

Background : While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) – a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003.
Methods : The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant. Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics.
Results : Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 – 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors.
Conclusion : Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses.

When the whole 'bloke' thing starts to crumble : men's access to chronic illness (arthritis) self management programs

This thesis explores the issue of men's access to chronic illness self management programs from a social constructionist perspective. A combination of research methodologies was used; a quantitative analysis to confirm gender differences in levels and patterns of service use; a qualitative analysis to gain an increased understanding of the factors affecting men's access; and a trial to test the application of the research findings. The clients and services of Arthritis Victoria were chosen as the setting for this research. The quantitative analyses were conducted on contingency tables and odds ratios and confirmed that men were under-represented as service users. The analyses also identified gender differences in patterns of service use. The qualitative analysis was based on a series of in-depth, semi-structured interviews. It was undertaken from a grounded theory approach to allow for the development of theoretical explanations grounded in the data. It was found that men's decisions to access chronic illness self management programs were strongly influenced by dominant social constructions of masculinity which constrained help-seeking and health management behaviour. However, the restrictive influence of hegemonic masculinity was progressively undermined by the increasing severity of the chronic condition until a crisis point was reached in terms of the severity of the condition or its impact on lifestyle. This resulted in a reformulation or rejection of hegemonic masculinity. The described conceptual framework was consistent for men from diverse social groupings, although it appeared less prominent in both younger and older men, suggesting that dominant social constructions of masculinity have the greatest influence on health decisions during the middle stage of adulthood when work and family obligations are greatest. The thesis findings informed the development of some guiding principles for reviewing the structure and delivery of chronic illness self management services for men. The guiding principles will have direct application in the planning of Arthritis Victoria programs, and implications for other chronic illness self management programs in Australia, and also in Western countries with a similar health and sociocultural setting to Australia.

Microwave-assisted direct amination : rapid access to multi-functionalized N6-substituted adenosines

Analogues of adenosine have a range of interesting biological activities and potential therapeutic applications. A method for the efficient preparation of highly functionalized N6-substituted adenosines has been developed from the corresponding tert-butyldimethylsilyl-protected inosine. The key step in this procedure is a microwave-assisted amination reaction between an appropriately substituted inosine and an amine in the presence of PyBroP. High yields of desired N6-substituted adenosines were achieved with hindered amines and the reaction was also found to accommodate a range of substituents on the inosine precursor.

The role of traditional knowledge and access to genetic resources in biodiversity conservation in Southeast Asia

The article examines international treaties linking trade and environment, their governance models and implementation in the context of Southeast Asia. Particular attention is being paid to the role of intellectual property concepts, customary law and traditional knowledge as incentives for biodiversity conservation and to difficulties in defining the subject matter and communities of knowledge holders. Indonesia’s regulation of traditional knowledge and access to biodiversity is discussed as example. The article concludes that national development goals and interests in royalty collection frequently dominate the discussion and that key concepts are still insufficiently defined to avoid overlaps and conflicts. Genuine local support for the conservationist aims of the models will depend on whether a benefit flow to communities can be ensured and their original role to act as incentives can be realised. International collaboration is important to avoid disputes concerning biodiversity related knowledge held across borders.