Health-related quality of life in Australian children with asthma: lessons for the cross-cultural use of quality of life instruments

The development of Australian forms of the Childhood Asthma Questionnaires (CAQs) is reported. Focus group methods and psychometric analyses were used to establish the conceptual, semantic and technical equivalence of these forms with the UK versions. Both versions also provide for data collection from non-asthmatic youngsters. The internal consistency was found to be acceptable (Cronbach's alpha 0.52-0.90) and the health-related quality of life (HRQoL) scores were found to vary with asthma severity (p < 0.05). Comparison with the UK data revealed that the non-asthmatic scores were higher for Australian than British children (p < 0.001) but that the scores for children with asthma did not differ between the two countries. It was only In the Australian sample that the group with asthma reported impaired HRQoL when compared to their healthy peers. These findings were interpreted in the context of cultural expectations of life quality and conclusions are presented regarding the importance of the gap between experience and expectations. The difficulties raised by the developmental and cultural issues inherent in paediatric HRQoL research were discussed. Qual. Life Res. 7:409-419 (C) 1998 Kluwer Academic Publishers

Cultural revolution in whale songs

Humpbacks have picked up a catchy tune sung by immigrants from a distant ocean. The song patterns of humpback whales (Megaptera novaeangliae) depend on where they live, with populations inhabiting different ocean basins normally singing quite distinct songs. Here we record a unique and radical song change in the song of humpback whales in the Pacific Ocean off the Australian east coast. Their song was replaced rapidly and completely by the song of the Australian west coast population from the Indian Ocean, apparently as a result of the introduction of only a small number of 'foreign' singers. Such a revolutionary change is unprecedented in animal cultural vocal traditions and suggests that novelty may stimulate change in humpback whale songs.

Lessons from a comprehensive clinical audit of users of psychiatric services who committed suicide

Objective: Characteristics of patients who committed suicide were examined to provide a picture of the treatment they received before death and to determine whether and how the suicides could have been pre vented by the service system. Methods: The unnatural-deaths register was matched to the psychiatric case register in the state of Victoria in Australia to identify suicides by people with a history of public-sector psychiatric service use who committed suicide between July 1, 1989, and June 30, 1994. Data on patient and treatment characteristics were examined by three experienced clinicians, who made judgments about whether the suicide could have been prevented had the service system responded differently. Quantitative and qualitative data were descriptively analyzed. Results: A total of 629 psychiatric patients who had committed suicide were identified. Seventy-two percent of the patients were male, 62 percent were under 40 years old, and 51 percent were unmarried. They had a range of disorders, with the most common being schizophrenia or schizoaffective disorder (36 percent). Sixty-seven percent had previously attempted suicide. A total of 311 patients (49 percent) received care within four weeks of death. Twenty percent of the suicides were considered preventable. Key factors associated with preventability were poor staff-patient relationships, incomplete assessments, poor assessment and treatment of depression and psychological problems, and poor continuity of care. Conclusions: Opportunities exist for the psychiatric service system to alter practices at several levels and thereby reduce patient suicides.

Developing a reliable audit instrument to measure the physical environment for physical activity

Background: The physical environment plays an important role in influencing participation in physical activity, although which factors of the physical environment have the greatest effect on patterns of activity remain to be determined. We describe the development of a comprehensive instrument to measure the physical environmental factors that may influence walking and cycling in local neighborhoods and report on its reliability. Methods: Following consultation with experts from a variety of fields and a literature search, we developed a Systematic Pedestrian and Cycling Environmental Scan (SPACES) instrument and used it to collect data over a total of 1987 kilometers of roads in metropolitan Perth, Western Australia. The audit instrument is available from the first author on request. Additional environmental information was collected using desktop methods and geographic information systems (GIS) technology. We assessed inter- and intra-rater reliability of the instrument among the 16 observers who collected the data. Results: The observers reported that the audit instrument was easy to use. Both inter- and intra-rater reliability of the environmental scan instrument were generally high. Conclusions: Our instrument provides a reliable, practical, and easy to-use method for collecting detailed street-level data on physical environmental factors that are potential influences on walking in local neighborhoods.

Social class and cultural mobility - Reconfiguring the cultural omnivore thesis

This article explores the idea of 'cultural mobility' both as a way of thinking about the polarizing logic of class relations and practices in contemporary society and as a means by which the debate over the cultural omnivore might be advanced. The concept of cultural mobility refers to the differential capacity to engage with or consume cultural goods and services across the entire spectrum of cultural life, an ability which is itself premised upon an unequal, class-related distribution in cultural competence. Cultural mobility, then, is the ability to move at will between cultural realms, a freedom to choose where one is positioned in the cultural landscape. I argue that the concept provides fertile ground for exploring possible interconnections between a number of divergent strands in current social theory which have largely developed independently of each other. At the same time much of this theoretical effort remains divorced from concrete research agendas. Using data collected as part of a major study of Australian cultural consumption, the article provides a case study of cultural mobility and its class moorings which serves to clarify some of the existing confusions concerning the cultural omnivore.

Country risk, national cultural differences between partners and survival of international joint ventures in Brazil

This article aims to identify the main and interaction effects of two country-level variables, namely national distance and country risk, on the survival of international joint ventures in emerging markets. Research hypotheses predicting the negative impact of national distance and country risk on survival of international joint ventures are formulated in this article. These research hypotheses are examined in a sample of 234 international joint ventures formed in Brazil between 1973 and 2004. These international joint ventures were subjected to an event history analysis over a period of time ranging from 1973 to 2006. The empirical results show that large national cultural differences between local and foreign partners increase the instability of international joint ventures, whereas the survival of these alliances does not seem to be affected either by the economic and political uncertainty of Brazil. Furthermore, the national distance between local and foreign partners has effects on survival that are variable according to the life cycle of international joint ventures. (C) 2007 Elsevier Ltd. All rights reserved.

National audit of anaesthesia for major abdominal surgery

A postal survey was conducted of all hospitals in Australia known to have a department of anaesthesia and an intensive care or high dependency unit. Each hospital was asked to report the anaesthetic and postoperative analgesic techniques used for the last ten cases of four common major surgical procedures-aorto-femoral bypass, repair of an abdominal aortic aneurysm, hemicolectomy and anterior resection of the rectum. Half of 76 hospitals sent a survey form completed and returned it. Responding hospitals were larger on average, than non-responding ones, but otherwise typical of them in terms of university affiliation and metropolitan versus rural location. For each of the procedures studied the proportion of cases in which epidural block was used intra- or postoperatively varied from 0% to 100%. Depending on the procedure, between 65% and 85% of hospitals used epidural block sometimes, with between 10% and 90% of patients in these hospitals being managed with this technique. There is wide variation in the use of epidural block, intra- and postoperatively, in Australia, variation that is unlikely to be explained by systematic differences between institutions in the patients seen or their suitability for one or other technique. This pattern of practice mirrors the lack of agreement about the proper place for epidural techniques evident in the recent literature. There is a widespread belief among clinicians that this is a question of great importance. Accordingly, we believe that anaesthetists and surgeons share an ethical responsibility to enter suitable patients in an appropriately designed randomized controlled trial in order to resolve this question.

Young people's beliefs about intergenerational communication - An initial cross-cultural comparison

This article examines young people's perceptions of their conversations with older people (age 65-85) across nine cultures-five Eastern and four Western. Responses from more than 1,000 participants were entered into a cross-national factor analysis, which revealed four initial factors that underlie perceptions of intergenerational conversations. Elder nonaccommodation was when young participants reported that older people negatively stereotyped the young and did not attend to their communication needs. On the other hand, elder accommodation was when older people were perceived as supportive, attentive and generally encouraging to young people. A third factor was respect/obligation and a fourth factor labeled age-irrelevant positivity described a situation where young people felt conversations with much older people were emotionally positive and satisfying, age did not matter: Examining cross-cultural differences, some East versus West differences were observed, as might be expected, on the basis of simplistic accounts of Eastern collectivism versus Western individualism. However the results challenge commonsense notions of the status of old age in Eastern versus Western cultures. On some dimensions, participants from Korea, Japan, People's Republic of China, Hong Kong, and the Philippines appear to have relatively less positive perceptions of their conversations with older people than the Western cultures-the United States, Australia, New Zealand and Canada. But there was also evidence of considerable cultural variability, particularly among Eastern cultures-variability that has heretofore all too often been glossed over when global comparisons of East versus West are made. A range of explanations for these cultural differences is explored and implications for older people in these societies are also considered.

Brazilian version of the Functional Assessment Measure: cross-cultural adaptation and reliability evaluation

The objective of this prospective study was to perform a cross-cultural adaptation of the Functional Assessment Measure (FAM) into Brazilian Portuguese, and to assess the test-retest reliability. The instrument was translated, back-translated, pretested, and reviewed by a committee. The Brazilian version was assessed in 61 brain-injury patients. Intrarater and interrater reliability was verified by a test-retest procedure (intraclass correlation). Intrarater reliability was moderate-to-excellent; interrater reliability was moderate-to-excellent, with the exception of one item. The Brazilian version of the FAM has acceptable test-retest reliability. Results suggest the use of the Brazilian version of the FAM in the Brazilian population, for disability evaluation and outcome assessment. Further research is required to evaluate the psychometric properties of the scale. International Journal of Rehabilitation Research 34:89-91 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.