Learning about inclusion from developing countries : using the index for inclusion

There is a need for a more critical perspective and reporting about the value of taking a model of inclusion developed in western countries and based upon the human rights ethos applying it in developing countries. This chapter will report firstly on how the Index for Inclusion (hereinafter referred to as the Index) was used in Australia as a tool for review and development; and secondly how the process of using the Index is adjusted for use in the Pacific Islands and other developing nations in collaborative and culturally sensitive ways to support and evaluate progress towards inclusive education. Examples are provided from both contexts to demonstrate the impact of the Index as an effective tool to support a more inclusive response to diversity in schools.

Bisphenol A exposure is not associated with area-level socioeconomic index in Australian children using pooled urine samples

Bisphenol A (BPA) is used extensively in food-contact materials and has been detected routinely in populations worldwide, and this exposure has been linked to a range of negative health outcomes in humans. There is some evidence of an association between BPA and different socioeconomic variables which may be the result of different dietary patterns. The aim of this study was to conduct a preliminary investigation of the association between BPA and socioeconomic status in Australian children using pooled urine specimens and an area level socioeconomic index. Surplus pathology urine specimens collected from children aged 0-15 years in Queensland, Australia as samples of convenience (n = 469) were pooled by age, sex and area level socioeconomic index (n = 67 pools), and analysed for total BPA using online solid phase extraction LC-MS/MS. Concentration ranged from 1.08-27.4 ng/ml with geometric mean 2.57 ng/ml, and geometric mean exposure was estimated as 70.3 ng/kg d-1. Neither BPA concentration nor excretion was associated with age or sex, and the authors found no evidence of an association with socioeconomic status. These results suggest that BPA exposure is not associated with socioeconomic status in the Australian population due to relatively homogenous exposures in Australia, or that the socioeconomic gradient is relatively slight in Australia compared with other OECD countries.

When the five giants of post war reconstruction meet the four pillars of welfare reform-young people lose out, again

This paper discusses proposed changes to the Australian welfare state in the Welfare Review chaired by Patrick McClure and launched by Kevin Andrews, Minister for Social Services in the Abbott government, in a recent address to the Sydney Institute. Andrews cited the Beveridge Report of 1942, referring to Lord William Beveridge as the “godfather of the British post-war welfare state”, commending him for putting forward a plan for a welfare state providing a minimal level of support, constituting a bare safety net, rather than “stifling civil society and personal responsibility” through generous provision. In line with a key TASA conference theme of challenging institutions and identifying social and political change at local and global levels, this paper examines both the Beveridge Report and the McClure Report, identifying key issues and themes of relevance to current times in Australia.

Queensland's budget austerity and its impact on social welfare : is the cure worse than the disease?

While considerable attention has been paid to the austerity experiments in Europe, much less attention has been paid to austerity case studies from other parts of the world. This paper examines the case of Queensland, Australia, where the government has pursued austerity measures, while making dire warnings that unless public debt was slashed and the public service sector downsized,Queensland risked becoming the Spain of Australia. The comparison is incomprehensible, given the very different economic situation in Queensland compared with Spain. This comparison constructed a sense of crisis that helped to mask standard neoliberal economic reform. While pursuing neoliberal economic policies,the Queensland Government has also been introducing draconian laws that limit civil liberties and political freedoms for ordinary citizens. This mix of authoritarianism and austerity has met considerable resistance, and this dynamic is discussed in the paper, along with the predictable and unequal impact that austerity measures have had on the general population and social services.

Development of a new index of balance in adults with intellectual and developmental disabilities

Purposes: The first objective was to propose a new model representing the balance level of adults with intellectual and developmental disabilities (IDD) using Principal Components Analysis (PCA); and the second objective was to use the results from the PCA recorded by regression method to construct and validate summative scales of the standardized values of the index, which may be useful to facilitate a balance assessment in adults with IDD. Methods: A total of 801 individuals with IDD (509 males) mean 33.1±8.5 years old, were recruited from Special Olympic Games in Spain 2009 to 2012. The participants performed the following tests: the timed-stand test, the single leg stance test with open and closed eyes, the Functional Reach Test, the Expanded Timed-Get-up-and-Go Test. Data was analyzed using principal components analysis (PCA) with Oblimin rotation and Kaiser normalization. We examined the construct validity of our proposed two-factor model underlying balance for adults with IDD. The scores from PCA were recorded by regression method and were standardized. Results: The Component Plot and Rotated Space indicated that a two-factor solution (Dynamic and Static Balance components) was optimal. The PCA with direct Oblimin rotation revealed a satisfactory percentage of total variance explained by the two factors: 51.6 and 21.4%, respectively. The median score standardized for component dynamic and static of the balance index for adults with IDD is shown how references values. Conclusions: Our study may lead to improvements in the understanding and assessment of balance in adults with IDD. First, it confirms that a two-factor model may underlie the balance construct, and second, it provides an index that may be useful for identifying the balance level for adults with IDD.

Locating Indigenous Australia within community development practice : clients, consumers or change makers?

The philosophical promise of community development to “resource and empower people so that they can collectively control their own destinies” (Kenny 1996:104) is no doubt alluring to Indigenous Australia. Given the historical and contemporary experiences of colonial control and surveillance of Aboriginal bodies, alongside the continuing experiences of socio-economic disadvantage, community development reaffirms the aspirational goal of Indigenous Australians for self-determination. Self-determination as a national policy agenda for Indigenous Australians emerged in the 1970s and saw the establishment of a wide range of Aboriginal community-controlled services (Tsey et al 2012). Sullivan (2010:4) argues that the Aboriginal community controlled service sector during this time has, and continues to be, instrumental to advancing the plight of Indigenous Australians both materially and politically. Yet community development and self-determination remain highly problematic and contested in how they manifest in Indigenous social policy agendas and in practice (Hollinsworth 1996; Martin 2003; McCausland 2005; Moreton-Robinson 2009). Moreton-Robinson (2009:68) argues that a central theme underpinning these tensions is a reading of Indigeneity in which Aboriginal and Torres Strait Islander people, behaviours, cultures, and communities are pathologised as “dysfunctional” thus enabling assertions that Indigenous people are incapable of managing their own affairs. This discourse distracts us from the “strategies and tactics of patriarchal white sovereignty” that inhibit the “state’s earlier policy of self-determination” (Moreton-Robinson 2009:68). We acknowledge the irony of community development espoused by Ramirez above (1990), that the least resourced are expected to be most resourceful.; however, we wish to interrogate the processes that inhibit Indigenous participation and control of our own affairs rather than further interrogate Aboriginal minds as uneducated, incapable and/or impaired...

The mechanical and inflammatory low back pain (MIL) index: development and validation

Abstract Background The purpose of this study was the development of a valid and reliable “Mechanical and Inflammatory Low Back Pain Index��� (MIL) for assessment of non-specific low back pain (NSLBP). This 7-item tool assists practitioners in determining whether symptoms are predominantly mechanical or inflammatory. Methods Participants (n = 170, 96 females, age = 38 ± 14 years-old) with NSLP were referred to two Spanish physiotherapy clinics and completed the MIL and the following measures: the Roland Morris Questionnaire (RMQ), SF-12 and “Backache Index��� (BAI) physical assessment test. For test-retest reliability, 37 consecutive patients were assessed at baseline and three days later during a non-treatment period. Face and content validity, practical characteristics, factor analysis, internal consistency, discriminant validity and convergent validity were assessed from the full sample. Results A total of 27 potential items that had been identified for inclusion were subsequently reduced to 11 by an expert panel. Four items were then removed due to cross-loading under confirmatory factor analysis where a two-factor model yielded a good fit to the data (χ2 = 14.80, df = 13, p = 0.37, CFI = 0.98, and RMSEA = 0.029). The internal consistency was moderate (α = 0.68 for MLBP; 0.72 for ILBP), test-retest reliability high (ICC = 0.91; 95%CI = 0.88-0.93) and discriminant validity good for either MLBP (AUC = 0.74) and ILBP (AUC = 0.92). Convergent validity was demonstrated through similar but weak correlations between the ILBP and both the RMQ and BAI (r = 0.34, p < 0.001) and the MLBP and BAI (r = 0.38, p < 0.001). Conclusions The MIL is a valid and reliable clinical tool for patients with NSLBP that discriminates between mechanical and inflammatory LBP. Keywords: Low back pain; Psychometrics properties; Pain measurement; Screening tool; Inflammatory; Mechanical

Assessing the welfare effects of microfinance in Vietnam : empirical results from a quasi-experimental survey

This article analyses the effects of NGO microfinance programmes on household welfare in Vietnam. Data on 470 households across 25 villages were collected using a quasi-experimental survey approach to overcome any self-selection bias. The sample was designed so that member households of microfinance programmes were compared with non-member households with similar characteristics. The analysis shows no significant effects of participation in NGO microfinance on household welfare, proxied by income and consumption per adult equivalent.

Developing countries and the potential of mandatory reporting laws to identify severe child abuse and neglect

This chapter considers the key characteristics of different types of child abuse and neglect, and outlines the nature and justifiability of mandatory reporting laws. The issue of whether these laws may be useful for child protection in developing countries with emerging economies is an important one. ‘Developing country’ is a term used by various institutions to describe a nation which has a lower living standard, industrial base, and human development index (HDI) compared to other countries (World Bank 2012; United Nations Development Programme 2013). In the context of developing countries, the chapter addresses two questions: first, might some forms of maltreatment be more suited to mandatory reporting than others? Second, what options for child protection may be considered by developing countries, taking into account children’s needs, cultural conditions and practices, economic imperatives, and the different levels of preparedness to implement child protection strategies?

Arabic translation, adaptation and modification of the dialysis symptom index for chronic kidney disease stages four and five

Background Symptom burden in chronic kidney disease (CKD) is poorly understood. To date, the majority of research focuses on single symptoms and there is a lack of suitable multidimensional symptom measures. The purpose of this study was to modify, translate, cross-culturally adapt and psychometrically analyse the Dialysis Symptom Index (DSI). Methods The study methods involved four phases: modification, translation, pilot-testing with a bilingual non-CKD sample and then psychometric testing with the target population. Content validity was assessed using an expert panel. Inter-rater agreement, test-retest reliability and Cronbach’s alpha coefficient were calculated to demonstrate reliability of the modified DSI. Discriminative and convergent validity were assessed to demonstrate construct validity. Results Content validity index during translation was 0.98. In the pilot study with 25 bilingual students a moderate to perfect agreement (Kappa statistic = 0.60-1.00) was found between English and Arabic versions of the modified DSI. The main study recruited 433 patients CKD with stages 4 and 5. The modified DSI was able to discriminate between non-dialysis and dialysis groups (p < 0.001) and demonstrated convergent validity with domains of the Kidney Disease Quality of Life short form. Excellent test-retest and internal consistency (Cronbach’s α = 0.91) reliability were also demonstrated. Conclusion The Arabic version of the modified DSI demonstrated good psychometric properties, measures the multidimensional nature of symptoms and can be used to assess symptom burden at different stages of CKD. The modified instrument, renamed the CKD Symptom Burden Index (CKD-SBI), should encourage greater clinical and research attention to symptom burden in CKD.

Development of a hybrid pollution index for heavy metals in marine and estuarine sediments

Heavy metal pollution of sediments is a growing concern in most parts of the world, and numerous studies focussed on identifying contaminated sediments by using a range of digestion methods and pollution indices to estimate sediment contamination have been described in the literature. The current work provides a critical review of the more commonly used sediment digestion methods and identifies that weak acid digestion is more likely to provide guidance on elements that are likely to be bioavailable than other traditional methods of digestion. This work also reviews common pollution indices and identifies the Nemerow Pollution Index as the most appropriate method for establishing overall sediment quality. Consequently, a modified Pollution Index that can lead to a more reliable understanding of whole sediment quality is proposed. This modified pollution index is then tested against a number of existing studies and demonstrated to give a reliable and rapid estimate of sediment contamination and quality.

Cross-cultural adaptation, reliability and validity of the Turkish version of the spine functional index

Background The Spine Functional Index (SFI) is a patient reported outcome measure with sound clinimetric properties and clinical viability for the determination of whole-spine impairment. To date, no validated Turkish version is available. The purpose of this study is to cross-culturally adapted the SFI for Turkish-speaking patients (SFI-Tk) and determine the psychometric properties of reliability, validity and factor structure in a Turkish population with spine musculoskeletal disorders. Methods The SFI English version was culturally adapted and translated into Turkish using a double forward and backward method according to established guidelines. Patients (n = 285, cervical = l29, lumbar = 151, cervical and lumbar region = 5, 73% female, age 45 ± 1) with spine musculoskeletal disorders completed the SFI-Tk at baseline and after a seven day period for test-retest reliability. For criterion validity the Turkish version of the Functional Rating Index (FRI) was used plus the Neck Disability Index (NDI) for cervical patients and the Oswestry Disability Index (ODI) for back patients. Additional psychometric properties were determined for internal consistency (Chronbach’s α), criterion validity and factor structure. Results There was a high degree of internal consistency (α = 0.85, item range 0.80-0.88) and test-retest reliability (r = 0.93, item range = 0.75-0.95). The factor analysis demonstrated a one-factor solution explaining 24.2% of total variance. Criterion validity with the ODI was high (r = 0.71, p < 0.001) while the FRI and NDI were fair (r = 0.52 and r = 0.58, respectively). The SFI-Tk showed no missing responses with the ‘half-mark’ option used in 11.75% of total responses by 77.9% of participants. Measurement error from SEM and MDC90 were respectively 2.96% and 7.12%. Conclusions The SFI-Tk demonstrated a one-factor solution and is a reliable and valid instrument. The SFI-Tk consists of simple and easily understood wording and may be used to assess spine region musculoskeletal disorders in Turkish speaking patients.