Comparison of access to medicines between Klang Valley and East Coast of peninsular Malaysia for children living in poor households

Purpose: To compare access to medicines in children living in poor households (income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia. Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, attitude and practice of parents in obtaining medicines for children. Results: There was no significant difference socio-demographically between poor households in Klang Valley (N = 58) and East Coast (N = 40). The study found that access to medicine for children (N = 325) in the households was adequate, where all households that reported illness in the children over the last 1 month and the last 6 month periods, obtained medicines and 99 % of the children were fully immunized. Qualitative analysis showed that poor households face several barriers in accessing medicines for their children such as financial, transportation, physical and attitudinal. Conclusion: Access to medicines for children living in poor households in both areas were similar and adequate. However, barriers to access remain and further studies are required.

A REMOTE SENSING APPROACH TO CHARACTERIZE THE HYDROGEOLOGY OF MOUNTAINOUS AREAS: APPLICATION TO THE QUITO AQUIFER SYSTEM (QAS), ECUADOR

Climate change, intensive use, and population growth are threatening the availability of water resources. New sources of water, better knowledge of existing ones, and improved water management strategies are of paramount importance. Ground water is often considered as primary water source due to its advantages in terms of quantity, spatial distribution, and natural quality. Remote sensing techniques afford scientists a unique opportunity to characterize landscapes in order to assess groundwater resources, particularly in tectonically influenced areas. Aquifers in volcanic basins are considered the most productive aquifers in Latin America. Although topography is considered the primary driving force for groundwater flows in mountainous terrains, tectonic activity increases the complexity of these groundwater systems by altering the integrity of sedimentary rock units and the overlying drainage networks. Structural controls affect the primary hydraulic properties of the rock formations by developing barriers to flow in some cases and zones of preferential infiltration and subterranean in others. The study area focuses on the Quito Aquifer System (QAS) in Ecuador. The characterization of the hydrogeology started with a lineament analysis based on a combined remote sensing and digital terrain analysis approach. The application of classical tools for regional hydrogeological evaluation and shallow geophysical methods were useful to evaluate the impact of faulting and fracturing on the aquifer system. Given the spatial extension of the area and the complexity of the system, two levels of analysis were applied in this study. At the regional level, a lineament map was created for the QAS. Relationships between fractures, faults and lineaments and the configuration of the groundwater flow on the QAS were determined. At the local level, on the Plateaus region of the QAS, a detailed lineament map was obtained by using high-spatial-resolution satellite imagery and aspect map derived from a digital elevation model (DEM). This map was complemented by the analysis of morphotectonic indicators and shallow geophysics that characterize fracture patterns. The development of the groundwater flow system was studied, drawing upon data pertaining to the aquifer system physical characteristics and topography. Hydrochemistry was used to ascertain the groundwater evolution and verify the correspondence of the flow patterns proposed in the flow system analysis. Isotopic analysis was employed to verify the origin of groundwater. The results of this study show that tectonism plays a very important role for the hydrology of the QAS. The results also demonstrate that faults influence a great deal of the topographic characteristics of the QAS and subsequently the configuration of the groundwater flow. Moreover, for the Plateaus region, the results demonstrate that the aquifer flow systems are affected by secondary porosity. This is a new conceptualization of the functioning of the aquifers on the QAS that will significantly contribute to the development of better strategies for the management of this important water resource.

A Historical Materialist Approach to the Eurozone Crisis: Fictitious Capital, States, and Capital Accumulation

This dissertation examines the ongoing European sovereign debt crises that began with Greece in 2009, in the wake of the US subprime mortgage crisis. Through the application of a historical materialist approach, I attempt to understand the on-going crisis in the European Monetary Union (EMU) by investigating root causes of sovereign debt crises, relations of power, and main beneficiaries of the policy responses. My theoretical framework hinges on three contradictions in capitalism: the tendency towards overaccumulation, the tension between fictitious capital and the productive base, and the contradiction inherent in capitalist states between their role as a national state and as a class state. In contrast to the dominant positions that locate the cause of the crisis within either: debtor states; creditor states; or the framework at the EMU, I argue that these sovereign debt crises are actually a broader crisis of crisis of capitalism within the EMU itself. In order to do so, I trace the evolution of the political economy of the Eurozone in the post-Bretton woods era, with a particularly focus on the credit system. More specifically, I argue that these crises are the result of an interaction between three meso-level contradictions that have developed within the EMU region: 1) Germany’s postwar accumulation regime, which has produced a deep crisis of overaccumulation; 2) the contradictory processes associated with the neoliberal logic of the EMU, by which I mean the rush to lower barriers to credit and finance at the expense of all else; and 3) credit-fueled, consumption-based EMU integration in the periphery; and. These three contradictions came together in the wake of the 2007-2008 US subprime crisis to form an overall crisis of capitalism in the Eurozone, expressed, as I suggest, as a crisis of fictitious capital. This dissertation aims to contribute to the ongoing project among critical political economists to de-naturalize and re-politicize money, while challenging the hegemony of monetarism within neoliberalism. Second, there has yet to be a comprehensive study that examines the EMU, Germany, and the crises in the periphery from a holistic, historical materialist analysis.

Youth-Physical Activity Towards Health: evidence and background to the development of the Y-PATH physical activity intervention for adolescents

Background: Despite known benefits of regular physical activity for health and well-being, many studies suggest that levels of physical activity in young people are low, and decline dramatically during adolescence. The purpose of the current research was to gather data on adolescent youth in order to inform the development of a targeted physical activity intervention. Methods: Cross-sectional data on physical activity levels (using self report and accelerometry), psychological correlates of physical activity, anthropometic characteristics, and the fundamental movement skill proficiency of 256 youth (53% male, 12.40 ± 0.51 years) were collected. A subsample (n = 59) participated in focus group interviews to explore their perceptions of health and identify barriers and motivators to participation in physical activity. Results: Findings indicate that the majority of youth (67%) were not accumulating the minimum 60 minutes of physical activity recommended daily for health, and that 99.5% did not achieve the fundamental movement skill proficiency expected for their age. Body mass index data showed that 25% of youth were classified as overweight or obese. Self-efficacy and physical activity attitude scores were significantly different (p < 0.05) between low, moderate and high active participants. Active and inactive youth reported differences in their perceived understanding of health and their barriers to physical activity participation, with active youth relating nutrition, exercise, energy and sports with the definition of ‘being healthy’, and inactive youth attributing primarily nutritional concepts to ‘being healthy’. Conclusions: Data show a need for targeting low levels of physical activity in youth through addressing poor health related activity knowledge and low fundamental movement skill proficiency. The Y-PATH intervention was developed in accordance with the present study findings; details of the intervention format are presented.

BRINGING STREET ART TO SCHOOL: OPEN TO INCLUDE

Inclusive Education values differences by reducing barriers to learning and promoting active participation and positive interactions between all members of school community. Nowadays, school faces numerous children/adolescents who for several reasons have developed challenging behaviours and high risk of dropping out school. They come often from socio-cultural-economic minority groups and have sometimes a repeated course of academic failure. Art has had the ability to bring together the interests of all, even of the most unsuitable. In this paper, the authors present an intervention through street art/graffiti done in a secondary school, with a ninth grade class covered by PIEF Programme. The project aimed to understand if the integration of graffiti art in educational process had impact on challenging behaviour. The study, with a qualitative methodology, shows contributions of artistic experience as an asset to educational development of students with challenging behaviours contributing to a better school and inclusion.

Medeleven

Medeleven was a practice-based research work that challenged conventional notions of how audiences ‘experience’ contemporary dance. It resulted in a 40 minute ‘experiential’ performance that inverted the traditional ‘passive’ presentation paradigm by situating the audience centrally within the creative process. The ‘traditional presentation paradigm’ was inverted in numerous ways including: asking the audience onstage with the performers, placing swings onstage for the audience to play on during the performance and guiding the audience through backstage corridors before entering onstage – all of which added elements of physicality, agency and liminality to the performance not usually available to audience members of contemporary dance. Five dancers moved throughout the space allowing the audience to choose where and how they engaged with this work and the swings were utilised both as a performance space and for audience seating. In addition to these spatial variations, the quadraphonic soundscore created distinct ‘environments’ throughout the stage space that varied individual experience possibilities. By positing performance as an experiential phenomenon, the pivotal objective of this work was to create a live-art experience that extended its performativity to include audience members as active meaning-makers, challenging both their role within this paradigm and their expectations of contemporary dance. The work produced strong responses from the audience with surveys indicating the presentation format, as well as the construction of the work, changed audience experience and ability to connect with the dance work. The research suggested that, in addition to existing research on dance audiences, barriers to engagement with contemporary dance may include how the art is constructed and where the audience is positioned within that creative framework. The research builds upon artistic practices being undertaken throughout the world that challenge the notion of existing ‘passive’ performance paradigms via creative ‘engagement’ with audience.

General practitioners’ experiences of the psychological aspects in the care of a dying patient

Objective: General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients. Method: Fifteen general practitioners whose patient had been recently referred to the Mt. Olivet Palliative Home Care Services in Brisbane participated in an individual case review discussions guided by key questions within a semistructured format. These interviews focused on the psychosocial aspects of care and management of the referred patient, including aspects of the doctor/patient relationship, experience of delivering diagnosis and prognosis, addressing the psychological concerns of the patients' family, and the doctors' personal experiences, reactions, and responses. Qualitative analysis was conducted on the transcripts of these interviews. Results: The significant themes that emerged related to perceived barriers to exploration of emotional concerns, including spiritual issues, and the discussion of prognosis and dying, the perception of patients' responses/coping styles, and the GP's personal experience of the care (usually expressed in terms of identification with patient). Significance of results: The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.

STRATÉGÉ – Study of Transparent Recognition, Accreditation Tools and Experience in a Global Environment

Engineering graduates of today, face a working environment that assumes global mobility in the labour market. This challenge means, amongst universities worldwide, a demand to increase the globalisation of educational programs, context, and increase and support the mobility of students through mechanisms such as student exchange and double masters degrees. Engineering student mobility from Australia is low with only a few Engineering Faculties encouraging students to go internationally. This comparative study, using universities in Australia and Europe, of feedback from students who have been on exchange or proposing to go on exchange, employers and faculty addresses the motivators and barriers to student mobility and exchange from the perspectives of the university, faculty, students and employers. Recommendations will be presented on how student mobility and exchange can be improved, and mechanisms such as double Masters Degrees, dual accreditation and Erasmus Mundus 2009 – 2013 can be utilised to improve student mobility.

Final report : offsite manufacture in Australia Final report off-site manufacture in Australia

Off-site Manufacture (OSM) has long been recognised, both in Australia and internationally, as offering numerous benefits to all parties in the construction process. More importantly, it is recognised as a key vehicle for driving improvement within the construction industry. The uptake of OSM in construction is however limited, despite well documented benefits. The research aims to determine the ‘state-of-the-art’ of OSM in Australia. It confirms the benefits and identifies the real and perceived barriers to the widespread adoption of OSM. Further the project identifies opportunities for future investment and research. Although numerous reports have been produced in the UK on the state of OSM adoption within that region, no prominent studies exist for the Australian context. This scoping study is an essential component upon which to build any initiatives that can take advantage of the benefits of OSM in construction. The Construction 2020 report predicted that OSM is set to increase in use over the next 5-15 years, further justifying the need for such a study. The long-term goal of this study is to contribute to the improvement of the Australian construction industry through a realisation of the potential benefits of OSM.

Business Drivers for BIM

his report describes in detail a project aimed at providing a better understanding of the business drivers and barriers to the adoption of Building Information Modelling (BIM) in the Architecture Engineering and Construction (AEC) and facility management (FM) industry sectors. The objectives of the project were to investigate the nature of economic, process and industry constraints to BIM adoption and then - if possible - to identify business strategies, and cost/benefit models that may support adoption of BIM in AEC/FM industry. The research was based on case studies from the property, construction and facility management sectors as well as other industries and interviews with business leaders and users of advanced applications of CAD in the industry.

Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

Developing capabilities for ongoing learning and change in intermediary programs

In dynamic environments, firms seek to build capabilities which will permit them to become innovation and change ready. Programs offered by intermediaries, while varying greatly in content and format, are designed to support those firms wishing to enhance their competitiveness. Firms which participate in intermediary programs have displayed their willingness to overcome deficiencies or barriers to competitiveness through acquiring knowledge which is external to the firm. This paper reports on interviews with 24 firms who were involved in a MAP or TAP program offered by QMI Solutions. The findings of the research suggest that knowledge intermediaries serve to disrupt organisational paths and in so doing establish mechanisms for ongoing learning and change. They do this first by disrupting the firm with a positive learning experience and also by establishing processes for developing new relationships and access to knowledge which are critical for learning and change. It is the experience of learning through knowledge exchange which can trigger the pursuit of new paths and it is the processes involving new relations and knowledge processing that provides the micro-foundations for ongoing learning and change. This suggests that the role of intermediaries goes well beyond merely knowledge transfer to include longer term effects on the capability of organisations to innovate, which is critical to economic competitiveness and the survival rate of firms.

CPR training in households of patients with chest pain

The objectives of this study are to (1) quantify prior cardiopulmonary resuscitation (CPR) training in households of patients presenting to the Emergency Department (ED) with or without chest pain or ischaemic heart disease (IHD); (2) evaluate the willingness of household members to undertake CPR training; and (3) identify potential barriers to the learning and provision of bystander CPR. A cross-sectional study was conducted by surveying patients presenting to the ED of a metropolitan teaching hospital over a 6-month period. Two in five households of patients presenting with chest pain or IHD had prior training in CPR. This was no higher than for households of patients presenting without chest pain or IHD. Just under two in three households of patients presenting with chest pain or IHD were willing to participate in future CPR classes. Potential barriers to learning CPR included lack of information on CPR classes, perceived lack of intellectual and/or physical capability to learn CPR and concern about causing anxiety in the person at risk of cardiac arrest. Potential barriers to CPR provision included an unknown cardiac arrest victim and fear of infection. The ED provides an opportunity for increasing family and community capacity for bystander intervention through referral to appropriate training.

Opportunities for enhancing the Australian national road safety strategy

With the current National Road Safety Strategy [1] coming to the end of its term, it is timely to consider ways in which the next iteration of this strategy can be enhanced. Strategic planning should be a cyclic process in which learning and adaptation are just as important as planning and implementation. It will always be the case that some actions are not as effective as expected, or that barriers to effective implementation will emerge. Rather than being setbacks, these are opportunities for learning about the validity of our assumptions. They are also opportunities for us to adapt to meet unanticipated or emerging challenges. One of the positive aspects of the implementation of the first and second National Road Safety Strategies has been the willingness of road safety agencies to critically assess progress and to identify where and how actions would be better focused. This has been reflected in the evolving nature of the periodic National Road Safety Action Plans. As the decade of the current Strategy reaches an end, there is a need to take this process further, and undertake a thorough critical evaluation of the Strategy development and implementation. While not an attempt to be exhaustive, the following article will identify some key priorities for consideration as part of this process.

Best Practice Guide : Consultants

The Guide contains the distilled findings from a major, two-year research project to explore those factors considered by industry practitioners to be critical to the successful adoption of ICT, both within their firms and between their firms and their trading partners. In the context of this project Critical Success Factors (CSFs) have been defined as, “Those things that absolutely, positively must be attended to in order to maximise the likelihood of a successful outcome for the stakeholder, defined in the stakeholder’s terms.” The guide includes: o Perceived benefits of ICT use across the consultants’ sector o Types and levels of ICT used across the sector o Self-assessment tool o CSFs for medium- and high-level ICT users, including o Best Practice Profiles o Action Statements o Barriers to ICT use for low-level users o Action Statements The material contained in this Guide has been generated following a number of principles: o For a given situation there is not a single ‘right answer’, but a number of solutions that have to be evaluated using a range of relevant factors. o As there are as many solutions as there are ‘solvers’, factors for evaluation will ‘emerge’ from collective wisdom.