Urban transit quality of service : user perception and behaviour

Despite its potential multiple contributions to sustainable policy objectives, urban transit is generally not widely used by the public in terms of its market share compared to that of automobiles, particularly in affluent societies with low-density urban forms like Australia. Transit service providers need to attract more people to transit by improving transit quality of service. The key to cost-effective transit service improvements lies in accurate evaluation of policy proposals by taking into account their impacts on transit users. If transit providers knew what is more or less important to their customers, they could focus their efforts on optimising customer-oriented service. Policy interventions could also be specified to influence transit users’ travel decisions, with targets of customer satisfaction and broader community welfare. This significance motivates the research into the relationship between urban transit quality of service and its user perception as well as behaviour. This research focused on two dimensions of transit user’s travel behaviour: route choice and access arrival time choice. The study area chosen was a busy urban transit corridor linking Brisbane central business district (CBD) and the St. Lucia campus of The University of Queensland (UQ). This multi-system corridor provided a ‘natural experiment’ for transit users between the CBD and UQ, as they can choose between busway 109 (with grade-separate exclusive right-of-way), ordinary on-street bus 412, and linear fast ferry CityCat on the Brisbane River. The population of interest was set as the attendees to UQ, who travelled from the CBD or from a suburb via the CBD. Two waves of internet-based self-completion questionnaire surveys were conducted to collect data on sampled passengers’ perception of transit service quality and behaviour of using public transit in the study area. The first wave survey is to collect behaviour and attitude data on respondents’ daily transit usage and their direct rating of importance on factors of route-level transit quality of service. A series of statistical analyses is conducted to examine the relationships between transit users’ travel and personal characteristics and their transit usage characteristics. A factor-cluster segmentation procedure is applied to respodents’ importance ratings on service quality variables regarding transit route preference to explore users’ various perspectives to transit quality of service. Based on the perceptions of service quality collected from the second wave survey, a series of quality criteria of the transit routes under study was quantitatively measured, particularly, the travel time reliability in terms of schedule adherence. It was proved that mixed traffic conditions and peak-period effects can affect transit service reliability. Multinomial logit models of transit user’s route choice were estimated using route-level service quality perceptions collected in the second wave survey. Relative importance of service quality factors were derived from choice model’s significant parameter estimates, such as access and egress times, seat availability, and busway system. Interpretations of the parameter estimates were conducted, particularly the equivalent in-vehicle time of access and egress times, and busway in-vehicle time. Market segmentation by trip origin was applied to investigate the difference in magnitude between the parameter estimates of access and egress times. The significant costs of transfer in transit trips were highlighted. These importance ratios were applied back to quality perceptions collected as RP data to compare the satisfaction levels between the service attributes and to generate an action relevance matrix to prioritise attributes for quality improvement. An empirical study on the relationship between average passenger waiting time and transit service characteristics was performed using the service quality perceived. Passenger arrivals for services with long headways (over 15 minutes) were found to be obviously coordinated with scheduled departure times of transit vehicles in order to reduce waiting time. This drove further investigations and modelling innovations in passenger’ access arrival time choice and its relationships with transit service characteristics and average passenger waiting time. Specifically, original contributions were made in formulation of expected waiting time, analysis of the risk-aversion attitude to missing desired service run in the passengers’ access time arrivals’ choice, and extensions of the utility function specification for modelling passenger access arrival distribution, by using complicated expected utility forms and non-linear probability weighting to explicitly accommodate the risk of missing an intended service and passenger’s risk-aversion attitude. Discussions on this research’s contributions to knowledge, its limitations, and recommendations for future research are provided at the concluding section of this thesis.

Young women's recent experience of labour and birth care in Queensland

Background Young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. Methods Secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15–20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. Results In the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. Conclusion This study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time.

Rural self-reliance: the impact on health experiences of people living with type II diabetes in rural Queensland, Australia

Objective: The objective of the study was to explore whether and how rural culture influences type II diabetes management and to better understand the social processes that rural people construct in coping with diabetes and its complications. In particular, the study aimed to analyse the interface and interactions between rural people with type II diabetes and the Australian health care system, and to develop a theoretical understanding that reflects constructs that may be more broadly applicable. Methods: The study applied constructivist grounded theory methods within an interpretive interactionist framework. Data from 39 semi-structured interviews with rural and urban type II diabetes patients and a mix of rural health care providers were analysed to develop a theoretical understanding of the social processes that define diabetes management in that context. Results: The analysis suggests that although type II diabetes imposes limitations that require adjustment and adaptation, these processes are actively negotiated by rural people within the environmental context to fit the salient social understandings of autonomy and self-reliance. Thus, people normalized self-reliant diabetes management behaviours because this was congruent with the rural culture. Factors that informed the actions of normalization were relationships between participants and health care professionals, support, and access to individual resources. Conclusions: The findings point to ways in which rural self-reliance is conceived as the primary strategy of diabetes management. People face the paradox of engaging with a health care system that at the same time maximizes individual responsibility for health and minimizes the social support by which individuals manage the condition. The emphasis on self-reliance gives some legitimacy to a lack of prevention and chronic care services. Success of diabetes management behaviours is, however, contingent on relative resources. Where there is good primary care, there develops a number of downstream effects including a sense of empowerment to manage difficult rural environmental circumstances. This has particular bearing on health outcomes for people with fewer resources.

A survey of the Queensland healthcare workforce : attitudes towards dementia care and training

Background Positive attitudes of healthcare staff towards people with dementia promote higher quality care, although little is known about important factors that underlie positive attitudes. Key aims of this project were to explore the relationships between staff attitudes towards dementia, self-confidence in caring for people with dementia, experience and dementia education and training. Method A brief online survey was developed and widely distributed to registered nurses and allied health professionals working in Queensland in 2012. Regression analyses were performed to identify important predictors of self-confidence in caring for people with dementia and positive attitudes towards people with dementia. Results Five hundred and twenty-four surveys were completed by respondents working in a range of care settings across Queensland. Respondents were predominantly female (94.1%), and most were registered nurses (60%), aged between 41 and 60 years (65.6%). Around 40% regularly worked with people with dementia and high levels of self-confidence in caring for this population and positive attitudes towards people with dementia were reported. The majority of respondents (67%) had participated in a dementia education/training activity in the past 12 months. More experience working with people with dementia predicted greater self-confidence while recent participation in a dementia education/training and higher self-confidence in caring for a person with dementia significantly predicted more positive attitudes towards people with dementia. Conclusion These results confirm the importance of self-confidence and dementia education in fostering positive attitudes and care practices towards people with dementia. Our results also indicate that the demand for ongoing dementia education is high amongst health care workers and it is recommended that regular dementia education/ training be provided and promoted for all healthcare personnel who work with people with dementia.

Developing examplars for sustained integration of palliative care principles into allied health curricula

The PCC4U (Palliative Care Curriculum for Undergraduates) project aims to support the inclusion of the principles and practice of palliative care in all health professional training. While uptake rates of the project resources and curriculum initiatives is strong in medicine and nursing (86% of courses actively engaged with the project in 2012) integration of palliative care content in allied health disciplines has been less consistent. This report explores the process adopted to address this issue. In 2012 six allied health courses – representing social work, pharmacy, psychology, occupational therapy, dietetics and physiotherapy – commenced a range of tailored curriculum initiatives with the aim of informing the development of exemplars of integration of palliative care in specific disciplines. The PCC4U project provided palliative care learning materials, curriculum resources and expertise, and financial support as part of this curriculum development process. Review of the outcomes of each initiative indicates that tailored support has provided an opportunity for courses to develop palliative care curriculum content that reflects both discipline and local contexts. It has contributed six discipline specific exemplars of the integration of palliative care in allied health professional curricula and provided insights into allied health educational approaches in palliative care, particularly the use of evidence based resources. As a result project curriculum materials and activities have been expanded. These will be implemented with allied health courses through workshops, site visits and curriculum mapping initiatives in 2013 to better sustain the integration of palliative care in health professional curricula.

Birth control : to what extent do women report being informed and involved in decisions about pregnancy and birth procedures?

Background: Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia. Methods: Participants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about their maternity care experiences, and who reported at least one of the nine procedures of interest. For each procedure, women answered two questions that measured perceived (i) receipt of information about the benefits and risks of the procedure and (ii) role in decision-making about the procedure. Results: In all, 3,542 eligible women (34.2%) completed the survey. Between 4% (for pre-labour caesarean section) and 60% (for vaginal examination) of women reported not being informed of the benefits and risks of the procedure they experienced. Between 2% (epidural) and 34% (episiotomy) of women reported being unconsulted in decision-making. Over one quarter (26%) of the women who experienced episiotomy reported being neither informed nor consulted. Conclusions: There is an urgent need for interventions that facilitate information provision and consumer involvement in decision-making about several perinatal procedures, especially those performed within the time-limited intrapartum care episode.

Professional conversations : a collaborative approach to support policy implementation, professional learning and practice change in ECEC

In 2012, Australia introduced a new National Quality Framework, comprising enhanced quality expectations for early childhood education and care services, two national learning frameworks and a new Assessment and Rating System spanning child care centres, kindergartens and preschools, family day care and outside school hours care. This is the linchpin in a series of education reforms designed to support increased access to higher quality early childhood education and care (ECEC) and successful transition to school. As with any policy change, success in real terms relies upon building shared understanding and the capacity of educators to apply new knowledge and to support change and improved practice within their service. With this in mind, a collaborative research project investigated the efficacy of a new approach to professional learning in ECEC: the professional conversation. This paper reports on the trial and evaluation of a series of professional conversations to support implementation of one element of the NQF, the Early Years Learning Framework (DEEWR,2009), and their capacity to promote collaborative reflective practice, shared understanding, and improved practice in ECEC. Set against the backdrop of the NQF, this paper details the professional conversation approach, key challenges and critical success factors, and the learning outcomes for conversation participants. Findings support the efficacy of this approach to professional learning in ECEC, and its capacity to support policy reform and practice change in ECEC.

Editorial : Action research, action learning and community services

This edition of ALARj has a focus on the contribution of action learning and action research to the development of community services, particularly nonprofits. The landscape of community services has been changing rapidly in recent decades, and can be typified by the notion of complexity. Complexity in the nature of issues that services seek to respond to, complexity in the policy environment and systems of support that have tended to silo and compartmentalise problems and people, and complexity in the institutional location non-profit services occupy in ‘helping’ those who are seen as ‘in need’ or marginalised. In addition to being typified by complexity the environment in which community services are located is dynamic, undergoing profound and ongoing change as neo-liberal approaches to understanding and responding to human need, which emphasise the individualisation of risk, and market principles such as choice, competition and innovation, drive social policy. How can long held values of empowerment, care, inclusivity and benefit to individuals and communities have expression in community services as they grapple with the challenges of being viable and relevant in such a dynamically changing environment? This edition brings together a range of contributions which speak to these challenges. The thematic through these is that processes are needed which engage services and communities in ongoing processes of inquiry about how they can best proceed in contexts typified by complexity and change. Action learning and action research can provide processes of this character.

Decoupling 2 : technologies, opportunities and policy options

This report was produced by the Decoupling Working Group of the International Resource Panel. It explores technological possibilities and opportunities for both developing and developed countries to accelerate decoupling and reap the environmental and economic benefits of increased resource productivity. It also examines several policy options that have proved to be successful in helping different countries to improve resource productivity in various sectors of their economy, avoiding negative impacts on the environment. It does not seem possible for a global economy based on the current unsustainable patterns of resource use to continue into the future. The economic consequences of these patterns are already apparent in three areas: increases in resource prices, increased price volatility and disruption of environmental systems. The environment impacts of resource use are also leading to potentially irreversible changes to the world’s ecosystems, often with direct effects on people and the economy – for example through damage to health, water shortages, loss of fish stocks or increased storm damage. But there are alternatives to these scary patterns. Many decoupling technologies and techniques that deliver resource productivity increases as high as 5 to 10-fold are already available, allowing countries to pursue their development strategies while significantly reducing their resource footprint and negative impacts on the environment. This report shows that much of the policy design “know-how” needed to achieve decoupling is present in terms of legislation, incentive systems, and institutional reform. Many countries have tried these out with tangible results, encouraging others to study and where appropriate replicate and scale up such practices and successes.

Longitudinal change in sleep and daytime sleepiness in postpartum women

Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12). Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce.

Maternal psychological distress mediates the relationship between asthma and physician visits in a population-based sample of adolescents

Objective This study examined whether maternal psychological distress mediates the relationship between presence of adolescent asthma and number of physician visits, and whether the association between maternal psychological distress and physician visits is moderated by adolescent general health. Methods Data were obtained from the Mater University Study of Pregnancy and included 4025 adolescents. Path analysis was used to examine mediating and moderating effects. Results Maternal psychological distress was found to partially mediate the relationship between adolescent asthma and number of physician visits, accounting for 25% of the effect of adolescent asthma on physician visits (p = .046). There was no evidence to suggest that adolescent general health moderated the association between maternal psychological distress and physician visits (p = .093). Conclusions The findings suggest that maternal psychological distress is associated with increased physician visits, regardless of adolescents' general health. Lowering maternal psychological distress may serve to reduce health care utilization and costs among adolescents with asthma.

The role of other people and emotion for blood donation : an altruistic social service

Blood donation is a critical part of health services with a viable blood supply underpinning an effective health program in any country. Typically blood is provided by voluntary donations from citizens and is therefore reliant on the goodwill and altruistic commitment of donors. In Australia, like many other developed nations, there are many challenges in maintaining a sufficient and sustainable blood supply. The Australian Red Cross Blood Service Donor and Community research group aim is to understand the barriers, motivations and perceptions of donors. Blood donation is a ‘people-processing’ service (Lovelock 1983, Russell-Bennett et al 2013) with the marketing exchange relating to bodily fluid rather than money and is an altruistic social service that has no direct benefit for the customer donor rather the benefit is for other people and society (Kotler and Zaltman 1971). Emotion has been shown to be a motivator and a barrier in a variety of Blood Service studies, this is a key insight that is further explored in the current study. Other key social factors that impact blood donor behavior are classified as social because they involve perceptions of other people’s beliefs and responses (such as moral or subjective norms), peer pressure, other people’s expectations and other people as a form of support. Given that emotions are social phenomena (Parkinson 1996), this study focuses on the role of other people in the blood donation process and how other people relates to the emotional experience of blood donors. We argue in this paper that overcoming emotional barriers to blood donation by leveraging the role of other people will influence low donation rates in Australia. To date, there has been little evidence in service research that identifies. In this paper we explore how other people influence the emotional experience of donors and how, donor emotions create the need for other people as a coping resource.

Women with self-reported lower-limb lymphedema after treatment for gynecological cancers: Are they more likely to self-report psychosocial symptoms and less likely to use services?

Background: Due to improved screening and treatment for gynaecological cancers survivorship has increased. Use of supportive care services after treatment is important to improve quality of life. Objective: To assess self-reported lower-limb lymphoedema (LLL), depression, anxiety, quality of life, unmet supportive care needs, and service use among gynaecological cancer survivors. Methods: In 2010 a population-based cross-sectional mail survey was conducted (n=160 gynaecological cancer survivors 5 to 30 month post-diagnosis (53% response rate)). Results: Overall, 30% of women self-reported LLL, 21% and 24% depression or anxiety, respectively. Women with LLL were more likely to also report symptoms of depression or anxiety, and with these symptoms had higher unmet supportive care needs. Services needed but not used by 10-15% of women with LLL, anxiety or depression respectively were lymphoedema specialist, pain specialist and physiotherapist, or psychiatrists, psychologists and pain specialists. Limitations: Small sample size, self-report data, limited generalisation to other countries, underrepresentation of older women (age >70) and women from non-Caucasian backgrounds. Conclusions: Women with LLL or high distress were less likely to use services they needed. Funding: This study was funded by Cancer Australia.

Workplace Learning in Physical Education : Emerging Teachers’ Stories from the Staffroom and Beyond

Pre-service and beginning teachers have to negotiate an unfamiliar and often challenging working environment, in both teaching spaces and staff spaces. Workplace Learning in Physical Education explores the workplace of teaching as a site of professional learning. Using stories and narratives from the experiences of pre-service and beginning teachers, the book takes a closer look at how professional knowledge is developed by investigating the notions of ‘professional’ and ‘workplace learning’ by drawing on data from a five year project. The book also critically examines the literature associated with, and the rhetoric that surrounds ‘the practicum’, ‘fieldwork’ ‘school experience’ and the ‘induction year’. The book is structured around five significant dimensions of workplace learning: Social tasks of teaching and learning to teach Performance, practice and praxis Identity, subjectivities and the profession/al Space and place for, and of, learning Micropolitics As well as identifying important implications for policy, practice and research methodology in physical education and teacher education, the book also shows how research can be a powerful medium for the communication of good practice. This is an important book for all students, pre-service and beginning teachers working in physical education, for academics researching teacher workspaces, and for anybody with an interest in the wider themes of teacher education, professional practice and professional learning in the workplace.

How to plan and implement an environmental education program for a conservation area : lessons from Australia and Borneo

The Augo Wetland Forest Park, along with other conservation areas around the world, provides an opportunity for a personal connection with the natural world - an opportunity for creating ways to convince people to reverse the degradation of the planet. In this presentation I use the settings approach, as used by the World Health Organisation in health promotion, as a framework. The WHO’s 1986 Ottawa Charter states that "Health is created and lived by people within the settings of their everyday life; where they learn, work, play, and love." I argue that, similarly, a conservation area provides a setting for people to connect with environmental issues and can be the place where positive behaviours and actions for the environment are created and enacted. In a wired and virtual world, such settings may be the only opportunity some people, especially children, get to connect with the environment. An evidence-based, intentionally designed and implemented environmental education program enhances the opportunities for the personal connection and subsequent action. Planning and implementing an Environmental education program for a conservation area requires an understanding of the principles of three domains: • Environmental Communication • Environmental Education • Environmental Interpretation In this presentation I define these domains and demonstrate how they become interdependent within the context of a particular setting such as a conservation area. I outline the principles of each domain and demonstrate how they can be enacted with reference to environmental education program case studies from settings in Australia and Borneo. The first case study is based around a proposal for a planned residential community at Eden’s Crossing, in Brisbane’s high growth Western corridor. The setting featured a number of important natural and heritage conservation characteristics and the developer wanted to be pro-active in informing the market what this development aims to achieve in terms of innovative community and environmental objectives. By designing an education and interpretation program in line with best practice education and interpretation principles the developers would be assisted in their efforts to build community, preserve heritage, and facilitate environmentally sensitive lifestyles for the future residents of Eden’s Crossing. Above all, the strategy focused on advancing sustainability in a way that made the Eden’s Crossing greenfield development significantly greener. It did this by interacting with prospective purchasers, and building knowledge about sustainability with a view to shaping the future community of Eden’s Crossing in terms of attitudes and behaviours. The second case study is based around the development of the Rainforest Interpretation Centre (RIC), now renamed the Rainforest Discovery Centre, an environmental education facility managed by the Sabah Forestry Department (SFD) and located at the edge of the Kabili-Sepilok Forest Reserve in the East Malaysian state of Sabah (Borneo). This setting is of paramount importance for biodiversity conservation and research and a vital habitat for orang utan. As an Environmental Education Consultant I was tasked with developing an environmental education program for this setting as part of the SFD’s long- term strategy towards sustainable forest management. By employing the principles of Environmental Education and Environmental Interpretation I designed and implemented a program with three major components: • an environmental education component for visiting primary and secondary school groups. • an environmental education component for in-service and pre-service teachers and teacher educators. • a public awareness and environmental interpretation component which caters for the general public and tourists. From these modest beginnings the program has expanded and new facilities have been developed to meet the demands of visitors, teachers and students. The effectiveness of the program can be traced back to the grounding in the principles of best practice environmental education, communication and interpretation.