Advice to consult a general medical practitioner in Western Australia : Could it be cancer?

Background: Many people will consult a medical practitioner about lower bowel symptoms, and the demand for access to general practitioners (GPs) is growing. We do not know if people recognise the symptoms of lower bowel cancer when advising others about the need to consult a doctor. A structured vignette survey was conducted in Western Australia. Method: Participants were recruited from the waiting rooms at five general practices. Respondents were invited to complete self-administered questionnaires containing nine vignettes chosen at random from a pool of 64 based on six clinical variables. Twenty-seven vignettes described high-risk bowel cancer scenarios. Respondents were asked if they would recommend a medical consultation for the case described and whether they believed the scenario was a cancer presentation. Logistic regression was used to estimate the independent effects of each variable on the respondent's judgement. Two-hundred and sixty-eight completed responses were collected over eight weeks. Results: The majority (61%) of respondents were female, aged 40 years and older. A history of rectal bleeding, six weeks of symptoms, and weight loss independently increased the odds of recommending a consultation with a medical practitioner by a factor of 7.64, 4.11 and 1.86, respectively. Most cases that were identified as cancer (75.2%) would not be classified as such on current research evidence. Factors that predict recognition of cancer presentations include rectal bleeding, weight loss and diarrhoea.

Critical reflection on the SIA’s professional project and the body of knowledge

Over the last few years the Safety Institute of Australia (SIA) has developed and implemented a number of strategies to gain professional status for the ‘generalist occupational health and safety professional’. Two of the most significant developments have been the publication of the ‘Core Body of Knowledge for the Generalist OHS Professional.’ and the accreditation of university OHS courses. Despite a considerable amount of work aimed at gaining professional status there has not been any public debate or reflection about how the professionalisation project may impact on OHS and how the project is being conducted. Professionalisation has been vigorously promoted as a sign of maturity for the SIA and which will provide unmitigated benefits for workplace health and safety. The aim of this paper is to critically reflect on the processes of professionalisation (the professional project) and discuss some of the ways in which this project may shape the field of occupational health and safety. The implications for the role of universities will also be discussed.

An exploratory study of staff nurses' knowledge of delirium in the medical ICU: An Asian perspective

Aim The aim of this study was to establish intensive care unit nurses’ knowledge of delirium within an acute tertiary hospital within South East Asia. Background Delirium is a common, life threatening and often preventable cause of morbidity and mortality among older patients. Undetected and untreated delirium is a catalyst to increased mortality, morbidity, functional decline and results in increased requirement for nursing care, healthcare expense and hospital length of stay. However, despite effective assessment tools to identify delirium in the acute setting, there still remains an inability of ICU nurses’ to accurately identify delirium in the critically ill patient especially that of hypoactive delirium. Method A purposive sample of 53 staff nurses from a 13-bedded medical intensive care unit within an acute tertiary teaching hospital in South East Asia were asked to participate. A 40 item 5-point Likert scale questionnaire was employed to determine the participants’ knowledge of the signs and symptoms; the risk factors and negative outcomes of delirium. Results The overall positively answered mean score was 27 (67.3%) out of a possible 40 questions. Mean scores for knowledge of signs and symptoms, risk factors and negative outcomes were 9.52 (63.5%, n = 15), 11.43 (63.5%, n = 17) and 6.0 (75%, n = 8), respectively. Conclusion Whilst the results of this study are similar to others taken from a western perspective, it appeared that the ICU nurses in this study demonstrated limited knowledge of the signs and symptoms, risk factors and negative outcomes of delirium in the critically patient. The implications for practice of this are important given the outcomes of untreated delirium.

Indigenous epistemology : creating an international Indigenous higher education space in the wake of the western “university of excellence”

Interest in the participation of Indigenous peoples in higher education has, in recent times, gained momentum with an increasing number of advocates challenging the global history of culturally inept policies and practices imposed within the western higher education system. To address the challenges being presented by Indigenous communities and other groups (often relegated under the banner of disadvantaged or equity) Western Universities are promoting a shift toward inclusive policies and practices. Frustrated with the offerings of the Western Higher Education system, a global movement of Indigenous academics, Elders and knowledge holders are developing strategies to meet the educational needs of their own communities, in order to find a way forward. The mobilization of Elders and Indigenous academics has resulted in the development of a global higher education network which is proving to be a significant force in changing the position of Indigenous participation in higher education. The World Indigenous Network Higher Education Consortium (WINHEC) has presented a significant challenge to those barriers within the western higher education system that has historically demonstrated an inability to develop culturally inclusive practices within their institutions. This paper examines the development of a world Indigenous higher education movement and its contribution to the history of the “university” within the context of western higher education institutions. Outlined in this examination will be a synopsis of the development of the “University of Excellence” and the creation of an international Indigenous space within higher education.

Changing views of culture, learning, teaching, and knowledge : Fiji in-service primary teachers

This paper explores in-service primary teachers' views and beliefs about culture, learning, teaching and knowledge. Fifty Bachelor of Education in-service primary teachers at a university in Fiji participated in the study. The analysis reveals a mix of old and new beliefs about culture, learning teaching and knowledge. The influence of globalization of technology is a contributing factor towards changing views. To keep the indigenous epistemologies alive and valued like the Western epistemologies, more effort is needed to integrate these in formal education. This has implications for the future professional preparation of pre-service and in-service teachers.

Albert Namatjira: copyright estates and traditional knowledge

Albert Namatjira was Australia's first Indigenous professional artist. He adapted Western-style painting to express his cultural knowledge of the Arrernte country, for which he was a traditional custodian. In his lifetime, Albert Namatjira achieved great acclaim for his exceptional ability as an artist. However, after his untimely death, he was ignored by the mainstream Australian art world, because of the aesthetic prejudices and social policies of the time. A recent exhibition entitled Seeing the Centre: The art of Albert Namatjira (1902-1959) curated by Alison French has sought to redress this neglect, and provide a retrospective of his work. The exhibition has brought to light that the copyright in the artistic works of Albert Namatjira has not been passed onto his family descendants. In June 1957, Namatjira entered into a copyright agreement with John Brackenreg, the owner of a publishing company by the name of Legend Press, and the associated Artarmon Galleries in Sydney. It was agreed that Legend Press would pay royalties to Namatjira for the sole right to reproduce all of his paintings. Following Namatjira's death in 1959, the administration of his estate passed to the Public Trustee for the Northern Territory Government. The Public Trustee of the Northern Territory Government authorised the sale of Namatjira's copyright to Legend Press in 1983, thereby ending the ability of the descendents of Namatjira to benefit from on-going income from the reproduction of his works. Senator Aden Ridgeway of the Democrats has called on the Federal Government to enter into discussions with the Northern Territory Government to buy back the copyright in Albert Namatjira's works. He argued that exclusive control of the use and reproduction of his works should be restored to his descendants, as well as the receipt of all financial benefits that result from the use and reproduction of his works under copyright protection. The Senator said: 'By doing this, we will all be rewarded, because finally, belatedly, we will be showing Albert Namatjira the reverence that he has always deserved. We will be protecting his legacy for future generations'.

Blame it on Rio: Biodiscovery, native title, and traditional knowledge

This article examines the legal responses to protect traditional knowledge of biodiversity in the wake of the Rio Convention on Biological Diversity. It considers the relative merits of the inter-locking regimes of contract law, environmental law, intellectual property law, and native title law. Part 1 considers the natural drug discovery industry in Australia. In particular, it looks at the operations of Amrad, Astra Zeneca R & D, and the Australian Institute of Marine Science. This section examines the key features of the draft regulations proposed under the Environment Protection and Biodiversity Conservation Act 1999 (Cth) - model contracts, informed consent, benefit-sharing, and ministerial discretion. The use of Indigenous Land Use Agreements in the context of access to genetic resources is also explored. Part 2 considers the role played by native title law in dealing with tangible and intangible property interests. The High Court decision in Western Australia v Ward considers the relationship between native title rights and cultural knowledge. The Federal Court case of Neowarra v Western Australia provides an intriguing gloss on this High Court decision. Part 3 looks at whether traditional knowledge of biodiversity can be protected under intellectual property law. It focuses upon reforms such as Senator Aden Ridgeway's proposed amendments to the Plant Breeder's Rights Act 1994 (Cth), and the push to make disclosure of origin a requirement of patent law.

Governance Matters : China's Developing Western Region with a Focus on Qinghai Province

This study is about governance in contemporary China. The focus is on Qinghai Province, one of the twelve provincial-level units included in the western region development strategy launched in 2000 by the government of China. Qinghai, the subject of the case study, is not a very well-known province. Hence, this study is significant, because it provides new knowledge about the province of Qinghai, its governance and diverse challenges, and deepens one s overall knowledge regarding China. Qinghai province is one of the slowest developing regions of China. My research problem is to analyze to what extent provincial development correlates with the quality of governance. The central concept of this research is good governance. This dissertation employs a grounded theory approach while the theoretical framework of this study is built on the Three World s approach of analyzing the three main themes, namely, the environment, economic development, and cultural diversity, and to support the empirical work. Philosophical issues in the humanities and contemporary theories of governance are brought in to provide deeper understanding of governance, and to understand to what extent and how characteristics of good governance (derived from the Western canon) are combined with Chinese tradition. A qualitative research method is chosen to provide a deeper understanding of the contemporary challenges of Qinghai (and China) and to provide some insight into the role and impact of governance on provincial development. It also focuses on the Tibetan ethnic group in order to develop as full an understanding as possible about the province. The challenges faced by Qinghai concern in particular its environment, economic development, and cultural diversity, all of which are closely interrelated. The findings demonstrate that Qinghai Province is not a powerful actor, because it has weak communications with the central government and weak collaboration with its stakeholders and civil society. How Qinghai s provincial government conducts provincial development remains a key question in terms of shaping the province s future. The question is how is Qinghai s government best able to govern in a way that is beneficial for the people. This study demonstrates that this is a significant question that challenges governance everywhere, and particularly in China given the absence of democracy. This study provides the ingredients for reflection as to how provincial government can be motivated to choose to govern in a sustainable way, instead of leaning on growth factors with too little consideration about the impact on the environment and the people.

Formative evaluation to benchmark and improve climate-based decision support for graziers in Western Queelsland

Researchers developing climate-based forecasts, workshops, software tools and information to aid grazier decisions undertook an evaluation study to enhance planning and benchmark impact. One hundred graziers in Western Queensland were randomly selected from 7 shires and surveyed by mail and telephone (43 respondents) to explore levels of knowledge and use of climate information, practices and information needs. We found 36% of respondents apply the Southern Oscillation Index to property decisions but 92% were unaware El Niño Southern Oscillation’s predictive signal in the region is greater for pasture growth than rainfall, suggesting they may not recognise the potential of pasture growth forecasts. Almost 75% of graziers consider they are conservative or risk averse in their attitude to managing their enterprise. Mail respondents (n= 20) if given a 68%, on average, probability of exceeding median rainfall forecast may change a decision; almost two-thirds vary stocking rate based on forage available, last year’s pasture growth or the Southern Oscillation Index; the balance maintain a constant stocking rate strategy; 90% have access to a computer; 75% to the internet and 95% have a fax. This paper presents findings of the study and draws comparisons with a similar study of 174 irrigators in the Northern Murray-Darling Basin (Aust. J. Exp. Ag. 44, 247-257). New insights and information gained are helping the team better understand client needs and plan, design and extend tools and information tailored to grazier knowledge, practice, information needs and preferences. Results have also provided a benchmark against which to measure project impact and have influenced the team to make important changes to their project planning, activities and methods for transferring technology tailored to grazier preferences.

Summative evaluation of climate application activities with pastoralists in western Queensland

Survey methods were engaged to measure the change in use and knowledge of climate information by pastoralists in western Queensland. The initial mail survey was undertaken in 2000-01 (n=43) and provided a useful benchmark of pastoralists climate knowledge. Two years of climate applications activities were completed and clients were re-surveyed in 2003 (n=49) to measure the change in knowledge and assess the effectiveness of the climate applications activities. Two methods were used to assess changes in client knowledge, viz., self-assessment and test questions. We found that the use of seasonal climate forecasts in decision making increased from 36% in 2001 (n=42) to 51% in 2003 (n=49) (P=0.07). The self-assessment technique was unsatisfactory as a measure of changing knowledge over short periods (1-3 years), but the test question technique was successful and indicated an improvement in climate knowledge among respondents. The increased levels of use of seasonal climate forecasts in management and improved knowledge was partly attributed to the climate applications activities of the project. Further, those who used seasonal forecasting (n=25) didn't understand key components of forecasts (e.g. probability, median) better than those who didn't use seasonal forecasts (n=24) (P>0.05). This identifies the potential for misunderstanding and misinterpretation of forecasts among users and highlights the need for providers of forecasts to understand the difficulties and prepare simply written descriptions of forecasts and disseminate these with the maps showing probabilities. The most preferred means of accessing climate information were internet, email, 'The Season Ahead' newsletter and newspaper. The least preferred were direct contact with extension officers and attending field days and group meetings. Eighty-six percent of respondents used the internet and 67% used ADSL broadband internet (April 2003). Despite these findings, extension officers play a key role in preparing and publishing the information on the web, in emails and newsletters. We also believe that direct contact with extension officers trained in climate applications is desirable in workshop-like events to improve knowledge of the difficult concepts underpinning climate forecasts, which may then stimulate further adoption.

A review of current knowledge of the weedy species Themeda quadrivalvis (grader grass)

This review of grader grass (Themeda quadrivalvis) attempts to collate current knowledge and identify knowledge gaps that may require further research. Grader grass is a tropical annual grass native to India that is now spread throughout many of the tropical regions of the world. In Australia, it has spread rapidly since its introduction in the 1930s and is now naturalised in the tropical areas of Queensland, the Northern Territory and Western Australia and extends south along the east coast to northern New South Wales. It is a vigorous grass with limited palatability, that is capable of invading native and improved pastures, cropping land and protected areas such as state and national parks. Grader grass can form dense monocultures that reduce biodiversity, decrease animal productivity and increase the fire hazard in the seasonally dry tropics. Control options are based on herbicides, grazing management and slashing, while overgrazing appears to favour grader grass. The effect of fire on grader grass is inconclusive and needs to be defined. Little is known about the biology and impacts of grader grass in agricultural and protected ecosystems in Australia. In particular, information is needed on soil seed bank longevity, seed production, germination and growth, which would allow the development of management strategies to control this weedy grass.

Resource Assessment of the Tidal Wetland Vegetation of Western Cape York Peninsula, North Queensland, Report to Ocean Rescue 2000

A project to allow the resource assessment of tidal wetland vegetation of western Cape York Peninsula, in north Queensland, was undertaken as part of the longterm assessment of the coastal fisheries resources of Queensland. The project incorporated a littoral invertebrate fauna component. Extending from May 1993 to December 1994, fieldwork was undertaken in May 1993, November 1993 and April 1994. The aims of this project were to: • obtain baseline information on the distribution of marine plants of western Cape York Peninsula; • commence a preliminary assessment of the littoral invertebrate fauna and their habitat requirements with a view to extending knowledge of their biogeographic affinities; • perform biogeographic classification of the tidal wetlands at a meso and local scale for marine conservation planning; • evaluate the conservation values of the areas investigated from the viewpoint of fisheries productivity and as habitat for important/threatened species. Dataset URL Link: Queensland Coastal Wetlands Resources Mapping data. [Dataset]

Consent Practices and Biomedical Knowledge Production in Tissue Economies

The use of human tissue sample collections has become an important tool in biomedical research. The collection, use and distribution of human tissue samples, which include blood and diagnostic tissue samples, from which DNA can be extracted and analyzed has also become a major bio-political preoccupation, not only in national contexts, but also at the transnational level. The foundation of medical research rests on the relationship between the doctor and the research subject. This relationship is a social one, in that it is based on informed consent, privacy and autonomy, where research subjects are made aware of what they are getting involved in and are then able to make an informed decision as to whether or not to participate. Within the post-genomic era, however, our understanding of what constitutes informed consent, privacy and autonomy is changing in relation to the needs of researchers, but also as a reflection of policy aspirations. This reflects a change in the power relations between the rights of the individual in relation to the interests of science and society. Using the notions of tissue economies and biovalue (Waldby, 2002) this research explores the changing relationship between sources and users of samples in biomedical research by examining the contexts under which human tissue samples and the information that is extracted from them are acquired, circulated and exchanged in Finland. The research examines how individual rights, particularly informed consent, are being configured in relation to the production of scientific knowledge in tissue economies in Finland from the 1990s to the present. The research examines the production of biovalue through the organization of scientific knowledge production by examining the policy context of knowledge production as well as three case studies (Tampere Research Tissue Bank, Hereditary Non-polyposis Colorectal Cancer and the Finnish Genome Information Center) in which tissues are acquired, circulated and exchanged in Finland. The research shows how interpretations of informed consent have become divergent and the elements and processes that have contributed to these differences. This inquiry shows how the relationship between the interests of individuals is re-configured in relation to the interests of science and society. It indicates how the boundary between interpretations of informed consent, on the one hand, and social and scientific interests, on the other, are being re-drawn and that this process is underscored, in part, by the economic, commercial and preventive potential that research using tissue samples are believed to produce. This can be said to fundamentally challenge the western notion that the rights of the individual are absolute and inalienable within biomedical legislation.

Knowledge through Discussion : An Interpretation of Epistemology in Plato's Meno

According to Meno s paradox we cannot inquire into what we do not know because we do not know what we are inquiring into. There are many ways to interpret the paradox but the central issue about our ability to reach truth is a profound one. In the dialogue Meno, Plato presents the paradox and an outline of a solution which enables us to reach knowledge (epistēmē) through philosophical discussion. During the last century Meno has often been considered transitional between Socratic thinking and Plato s own philosophy, and thus the dialogue has not been adequately interpreted as an integrated whole. Therefore the distinctive epistemology of the dialogue has not gained due notice. In this thesis the dialogue is analysed as an integrated whole and the philosophical interpretation also takes into account its dramatic features. The thesis emphasises the role of language and definitions in acquiring knowledge. Among the results concerning these subjects is a new interpretation of Socrates s defintion of shape (schēma). The theory of anamnēsis all learning is recollection in the Meno is argued to answer the paradox philosophically although Plato s presentation also contains playful and ironic elements. The background of the way Plato presents his case is that he appreciated the fact that no argument can plausibly demonstrate that argumentation is able to reach truth. In the Meno, Plato makes the earliest explicit distinction between knowledge and true belief in the history of Western philosophy. He also gives a definition of knowledge which is the basis of the so called classical definition of knowledge as justified true belief. In the Meno, true beliefs become knowledge when someone ties them down by reasoning about the explanation. The analysis of the epistemology of the dialogue from this perspective gives an interpretation which integrates the central concepts of the epistemology in the dialogue elenchos, anamnēsis and hypothetical inquiry into a unified whole which contains a plausible argument according to which the ignorant can reach knowledge through discussion. The conception that emerges by such an analysis is interesting both from the point of view of current interests and that of the history of philosophy. The method of knowledge acquisition in the Meno can, for example, be seen as a predecessor of modern scientific methods. The Meno is the earliest Greek mathematical text that has survived in its original form. The analysis presented in the thesis of the geometric passages in the dialogue provides new results both concerning Socrates s geometry lesson with the slave and the example presenting the hypothetical method. Concerning the latter, a new interpretation is presented. Keywords: anamnēsis, epistēmē, knowledge, Meno s paradox, Plato

Indigenous Knowledge for Biodiversity Conservation

Indigenous peoples with a historical continuity of resource-use practices often possess a broad knowledge base of the behavior of complex ecological systems in their own localities. This knowledge has accumulated through a long series of observations transmitted from generation to generation. Such ''diachronic'' observations can be of great value and complement the ''synchronic''observations on which western science is based. Where indigenous peoples have depended, for long periods of time, on local environments for the provision of a variety of resources, they have developed a stake in conserving, and in some cases, enhancing, biodiversity. They are aware that biological diversity is a crucial factor in generating the ecological services and natural resources on which they depend. Some indigenous groups manipulate the local landscape to augment its heterogeneity, and some have been found to be motivated to restore biodiversity in degraded landscapes. Their practices for the conservation of biodiversity were grounded in a series of rules of thumb which are apparently arrived at through a trial and error process over a long historical time period. This implies that their knowledge base is indefinite and their implementation involves an intimate relationship with the belief system. Such knowledge is difficult for western science to understand. It is vital, however, that the value of the knowledge-practice-belief complex of indigenous peoples relating to conservation of biodiversity is fully recognized if ecosystems and biodiversity are to be managed sustainably. Conserving this knowledge would be most appropriately accomplished through promoting the community-based resource-management systems of indigenous peoples.