Information support for health management in regional Sri Lanka : health managers’ perspectives

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka.

What makes inner city high density living attractive? Insight from residents in Brisbane, Australia

Australia’s urban form and planning has shifted from traditional individual dwellings on spacious suburban blocks towards higher density urban consolidation. Despite relatively strong market demand for inner city high density (ICHD) living, there is ongoing need to explore and understand the aspects that make this urban form liveable and sustainable. The purpose of this research is to explore the viewpoints of current ICHD residents to better understand the liveability and sustainability matters that affect their everyday experiences and perceptions of this urban form. Qualitative interviews with 24 ICHD Brisbane (Australia) residents illustrates their perceptions and experiences of liveability and the ways in which it is broadly understood within three main domains and nine key sub-concepts, including: individual dwelling (thermal comfort, natural light and balconies, noise mitigation), building complex (shared space, good neighbour protocols, environmental sustainability) and the community (transport, amenities, sense of community). Focussing on the experience of ICHD residents, this research highlights the ways in which multiple aspects of the immediate living environment, the dwelling, building complex and the community intertwine to provide residents with a liveable space. The results show that urban features that reflect current societal pressure for greater sustainability such as lower energy use are the exact same features sought by ICHD residents in determining their liveability. By highlighting the aspects current ICHD residents value most about their dwellings, buildings and communities, these findings will help inform policy-makers, planners, developers and designers as they create urban spaces and dwellings that are more liveable and sustainable.

Vestibular rehabilitation following the removal of an acoustic neuroma : a systematic review of randomized trials

An acoustic neuroma (also known as a vestibular schwannoma) is an intracranial tumour of the vestibular nerve that is commonly treated by surgical resection. Following resection of an acoustic neuroma, patients may experience a range of symptoms that include deficits in gaze stability, mobility and balance. Vestibular rehabilitation may be useful in reducing the severity and minimizing the impact of these symptoms.

The influence of parental health beliefs on child restraint practices in a regional centre in Queensland

Since March 2010 in Queensland, legislation has specified the type of restraint and seating row for child passengers under 7 years according to age. The following study explored regional parents’ child restraint practices and the influence of their health beliefs over these. A brief intercept interview was verbally administered to a convenience sample of parent-drivers (n = 123) in Toowoomba in February 2010, after the announcement of changes to legislation but prior to enforcement. Parents who agreed to be followed-up were then reinterviewed after the enforcement (May-June 2010). The Health Beliefs Model was used to gauge beliefs about susceptibility to crashing, children being injured in a crash, and likely severity of injuries. Self-efficacy and perceptions about barriers to, and benefits of, using age-appropriate restraints with children, were also assessed. Results: There were very high levels of rear seating reported for children (initial interview 91%; follow-up 100%). Dedicated child restraint use was 96.9% at initial interview, though 11% were deemed inappropriate for the child’s age. Self-reported restraint practices for children under 7 were used to categorise parental practices into ‘Appropriate’ (all children in age-appropriate restraint and rear seat) or ‘Inappropriate’ (≥1 child inappropriately restrained). 94% of parents were aware of the legislation, but only around one third gave accurate descriptions of the requirements. However, 89% of parents were deemed to have ‘Appropriate’ restraint practices. Parents with ‘Inappropriate’ practices were significantly more likely than those with ‘Appropriate’ practices to disagree that child restraints provide better protection for children in a crash than adult seatbelts. For self-efficacy, parents with ‘Appropriate’ practices were more likely than those with ‘Inappropriate’ practices to report being ‘completely confident’ about installing child restraints. The results suggest that efforts to increase the level of appropriate restraint should attempt to better inform them about the superior protection offered by child restraints compared with seat belts for children.

‘Hot chicks’, ‘better parties’ or academic stuff : perceptions of a regional university campus using Repertory Grid Analysis and Importance-performance Analysis

In the increasingly competitive Australian tertiary education market, a consumer orientation is essential. This is particularly so for small regional campuses competing with larger universities in the state capitals. Campus management need to carefully monitor both the perceptions of prospective students within the catchment area, and the (dis)satisfaction levels of current students. This study reports the results of an exploratory investigation into the perceptions held of a regional campus, using two techniques that have arguably been underutilised in the education marketing literature. Repertory Grid Analysis, a technique developed almost fifty years ago, was used to identify attributes deemed salient to year 12 high school students at the time they were applying for university places. Importance-performance analysis (IPA), developed three decades ago, was then used to identify attributes that were determinant for a new cohort of first year undergraduate students. The paper concludes that group applications of Repertory Grid offer education market researchers a useful means for identifying attributes used by high school students to differentiate universities, and that IPA is a useful technique for guiding promotional decision making. In this case, the two techniques provided a quick, economical and effective snapshot of market perceptions, which can be used as a foundation for the development of an ongoing market research programme.

Regional characteristics, opportunity perception and entrepreneurial activities

This paper seeks to better understand the link between regional characteristics and individual entrepreneurship. We combine individual-level GEM data for Western Germany with regional-level data, using multi-level analysis to test our hypotheses. We find no direct link between regional knowledge creation, the economic context and an entrepreneurial culture on the one side and individual business start-up intentions and start-up activity on the other side. However our findings point to the importance of an indirect effect of regional characteristics as knowledge creation, the economic context and an entrepreneurial culture have an effect on the individual perception of founding opportunities which in turn predicted start-up intentions and activity.

Who's afraid of China? The challenge of Chinese soft power [Review]

What role does China play in Western imagination and how does it affect Western selfconceptions? The rise of China as an alternative model to Western liberalism has created a fear that developing countries will stray from Western standards of democracy, transparency and human rights. However, such fears often say as much about those who hold them as they do about China itself. In this short and easily readable book Barr holds a mirror to Sino–Western relations in order to better understand how the West’s own past, hopes and fears shape the way it thinks about and engages with China. Focusing on three key areas—models of development, soft power and ethnocentrism—he argues that the rise of China ‘hits a nerve in the Western psyche . . . because its actions reflect the West’s own ambivalence to modernity and uncertainty over the proper role and limits of state power’ (p. 21). To make his point, Barr focuses on China’s soft power and the connections between China’s domestic politics and its attempts to shape its image internationally...

Large-scale community projects in regional Queensland : unlocking creative potential and community identity : Artspoken Queensland Regional Arts and Culture Conference 2011

In this presentation, renowned arts practitioner, Sean Mee, and Nigel Lavender, Executive Director of the Queensland Music Festival, talk about how community arts practice can be used to build cultural captial in communities, using examples such large-scale musicals such as The Road We're ON (Charleville) and Behind the Cand (Bowen), Mee and Lavender highlight the importance of community-driven narrative and particiaption.

The implications of cross-regional differences for the design of In-vehicle Information Systems : a comparison of Australian and Chinese drivers

The increasing global distribution of automobiles necessitates that the design of In-vehicle Information Systems (IVIS) is appropriate for the regions to which they are being exported. Differences between regions such as culture, environment and traffic context can influence the needs, usability and acceptance of IVIS. This paper describes two studies aimed at identifying regional differences in IVIS design needs and preferences across drivers from Australia and China to determine the impact of any differences on IVIS design. Using a questionnaire and interaction clinics, the influence of cultural values and driving patterns on drivers' preferences for, and comprehension of, surface- and interaction-level aspects of IVIS interfaces was explored. Similarities and differences were found between the two regional groups in terms of preferences for IVIS input control types and labels and in the comprehension of IVIS functions. Specifically, Chinese drivers preferred symbols and Chinese characters over English words and were less successful (compared to Australians) at comprehending English abbreviations, particularly for complex IVIS functions. Implications in terms of the current trend to introduce Western-styled interfaces into other regions with little or no adaptation are discussed.

Steps toward the validation of the Trendelenburg Test : the effect of experimentally reduced hip abductor muscle function on frontal plane mechanics

Objective: To investigate the validity of the Trendelenburg test (TT) using an ultrasound-guided nerve block (UNB) of the superior gluteal nerve and determine whether the reduction in hip abductor muscle (HABD) strength would result in the theorized mechanical compensatory strategies measured during the TT. Design: Quasi-experimental. Setting: Hospital. Participants: Convenience sample of 9 healthy men. Only participants with no current or previous injury to the lumbar spine, pelvis, or lower extremities, and no previous surgeries were included. Interventions: Ultrasound-guided nerve block. Main Outcome Measures: Hip abductor muscle strength (percent body weight [%BW]), contralateral pelvic drop (cPD), change in contralateral pelvic drop (Delta cPD), ipsilateral hip adduction, and ipsilateral trunk sway (TRUNK) measured in degrees. Results: The median age and weight of the participants were 31 years (interquartile range [IQR], 22-32 years) and 73 kg (IQR, 67-81 kg), respectively. An average 52% reduction of HABD strength (z = 2.36, P = 0.02) resulted after the UNB. No differences were found in cPD or Delta cPD (z = 0.01, P = 0.99, z = 20.67, P = 0.49, respectively). Individual changes in biomechanics showed no consistency between participants and nonsystematic changes across the group. One participant demonstrated the mechanical compensations described by Trendelenburg. Conclusions: The TT should not be used as a screening measure for HABD strength in populations demonstrating strength greater than 30% BW but should be reserved for use with populations with marked HABD weakness. Clinical Relevance: This study presents data regarding a critical level of HABD strength required to support the pelvis during the TT.

Steps towards the validation of the Trendelenburg test : The effect of experimentally reduced hip abductor muscle function on frontal plane mechanics

Introduction: The Trendelenburg Test (TT) is used to assess the functional strength of the hip abductor muscles (HABD), their ability to control frontal plane motion of the pelvis, and the ability of the lumbopelvic complex to transfer load into single leg stance. Rationale: Although a standard method to perform the test has been described for use within clinical populations, no study has directly investigated Trendelenburg’s hypotheses. Purpose: To investigate the validity of the TT using an ultrasound guided nerve block (UNB) of the superior gluteal nerve and determine whether the reduction in HABD strength would result in the theorized mechanical compensatory strategies measured during the TT. Methods: Quasi-experimental design using a convenience sample of nine healthy males. Only subjects with no current or previous injury to the lumbar spine, pelvis, or lower extremities, and no previous surgeries were included. Force dynamometry was used to evaluation HABD strength (%BW). 2D mechanics were used to evaluate contralateral pelvic drop (cMPD), change in contralateral pelvic drop (∆cMPD), ipsilateral hip adduction (iHADD) and ipsilateral trunk sway (TRUNK) measured in degrees (°). All measures were collected prior to and following a UNB on the superior gluteal nerve performed by an interventional radiologist. Results: Subjects’ age was median 31yrs (IQR:22-32yrs); and weight was median 73kg (IQR:67-81kg). An average 52% reduction of HABD strength (z=2.36,p=0.02) resulted following the UNB. No differences were found in cMPD or ∆cMPD (z=0.01,p= 0.99, z=-0.67,p=0.49). Individual changes in biomechanics show no consistency between subjects and non-systematic changes across the group. One subject demonstrated the mechanical compensations described by Trendelenburg. Discussion: The TT should not be used as screening measure for HABD strength in populations demonstrating strength greater than 30%BW but reserved for use with populations with marked HABD weakness. Importance: This study presents data regarding a critical level of HABD strength required to support the pelvis during the TT.

UNCLOS and regional action for protection of the marine environment : perspectives of the South Asian Seas region

In very clear language the United Nations Convention on the Law of the Sea (UNCLOS) calls upon the parties to initiate regional action for protection of marine environment. Although the UNCLOS gives special recognition in various ways to developing countries, the South Asian developing countries continue to encounter some bottlenecks in complying with the provisions of the Convention relating to marine environment. Against this backdrop, this paper tends to examine the need for a regional approach towards conservation of marine environment. Moreover, the paper aims to explore possible ways to establish a regional legal framework for conservation of marine environment in South Asian region. In doing so, the paper critically examines existing mechanisms already in place including the South Asian Seas Programme and South Asian Seas Action Plan

Discussion paper and working paper series : Motivations, expectations and experiences of Australian rural and regional planners

Despite playing an extremely important role in shaping communities, the role and contribution of planners is not widely understood or acknowledged. At the same time, there is a shortage of planners in Australia, especially in non-urban areas. Thus, though an online survey of 185 rural and regional planners, this research explores their motivations, expectations and experiences. Most enjoyed and felt confident in their role, explaining that they valued the relaxed family orientated rural lifestyle and the varied nature of the planning work. Although they sometimes felt isolated, the non-urban location provided quicker progression to senior roles, the ability to engage directly with the community and to see the consequences of their decisions. Only half felt their education had prepared them well for their role, citing gaps in terms of computerised modelling, team leadership and conflict resolution skills. Their feedback centred on providing a more practical course, focussing more on regional planning, and encouraging urban and rural experience placements. As the first study to quantifiably explore rural and regional Australian planners perceptions of their role and challenges, the findings illustrate current experiences, key planning challenges, perceived educational gaps and future priorities.

Determinants of regional innovation capacity in China

Since the 1980s, when the concept of innovation systems(IS) was first presented(Freeman, 2004), a large body of work has been done on IS. IS is a framework that consists of elements related to innovation activities, such as innovation actors,institutional environments, and the relationship between those elements (Lundvall,1992; Nelson, 1993). Studies on NIS/RIS aim to understand the structures and dynamics of IS (Lundvall, 1992; Nelson, 1993), mainly through case studies and comparative case studies(Archibugi, 1996; MacDowall, 1984; Mowery, 1998;Radosevic, 2000). Research on IS has extended from the national level (NIS) to the regional level (RIS) (Cooke, Uranga, & Etxebarria, 1997; Cooke, Uranga, & Etxebarria, 1998), and from developed economies to developing economies. RIS is vital, especially for a large and diverse countries(Edquist, 2004) like China. More recently, based on the literature of NIS, Furman, Porter and Scott (2002)introduced the framework of national innovation capacity (NIC), which employs a quantitative approach to understanding to what degree elements of NIS impact on innovation capacity. Regional innovation capacity (RIC) is the adaption of NIC at the regional level. Although regional level research is important there is limited work done on RIC and there is even less in transitional economies, which are different to developed countries. To better understand RIC in transitional countries this thesis conducted a study of 30 administrative regions in Mainland China between 1991 and 2005. To establish the key factors driving RIC in China the study explored the impact of three elements in the innovation system;(a) innovation actors, (b) innovation inputs, and (c)international and domestic innovation system interactions.