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.

Development, implementation and evaluation of a cancer survivor self-management care plan

Aim There is a growing population of people with cancer who experience physiological and psychological effects that persist long after treatment is complete. Interventions that enhance survivors’ self-management abilities might help offset these effects. The aim of this pilot study was to develop, implement and evaluate interventions tailored to assist patients to manage post-treatment health issues effectively. Method In this pre-post intervention cohort study, participants were recruited on completion of cancer treatment. Participants recruited preimplementation, who received usual care, comprised the control group. Participants recruited later formed the intervention group. In the intervention group, the Cancer Care Coordinator developed an individualised, structured Cancer Survivor Self-management Care Plan. Participants were interviewed on completion of treatment (baseline) and at three months. Assessments concerned health needs (CaSUN), self-efficacy in adjusting and coping with cancer and health-related quality of life (FACIT-B or FACT-C). The impact of the intervention was determined by independent t-tests of change scores. Results The intervention (n = 32) and control groups (n = 35) were comparable on demographic and clinical characteristics. Sample mean age was 54 + 10 years. Cancer diagnoses were breast (82%) and colorectal (18%). Statistically significant differences (p < 0.05) indicated improvement in the intervention group for: (a) functional well-being, from the FACIT, (Control: M = −0.69, SE = 0.91; Intervention: M = 3.04, SE = 1.13); and (b) self-efficacy in maintaining social relationships, (Control: M = −0.333, SE = 0.33; Intervention: M = 0.621, SE = 0.27). No significant differences were found in health needs, other subscales of quality of life, the extent and number of strategies used in coping and adjusting to cancer and in other domains of self-efficacy. Conclusions While the results should be interpreted with caution, due to the non-randomised nature of the study and the small sample size, they indicate the potential benefits of tailored self-management interventions warrant further investigation in this context.

Self-gifting guilt : an examination of self-gifting motivations and post-purchase regret

Purpose Self-gifting is a performative process in which consumers purchase products for themselves. The literature to date remains silent on a determination and connection between the extents of post-purchase regret resulting from self-gifting behavior. The purpose of this paper is to examine identification and connection of self-gifting antecedents, self-gifting and the effect on post purchase regret. Design/methodology/approach This study claims the two antecedents of hedonistic shopping and indulgence drive self-gifting behaviors and the attendant regret. A total of 307 shoppers responded to a series of statements concerning the relationships between antecedents of self-gifting behavior and the effect on post-purchase regret. Self-gifting is a multi-dimensional construct, consisting of therapeutic, celebratory, reward and hedonistic imports. Confirmatory factor analysis and AMOS path modeling enabled examination of relationships between the consumer traits of hedonistic shopping and indulgence and the four self-gifting concepts. Findings Hedonic and indulgent shoppers engage in self-gifting for different reasons. A strong and positive relationship was identified between hedonic shoppers and reward, hedonic, therapeutic and celebratory self-gift motivations. hedonic shoppers aligned with indulgent shoppers who also engaged the four self-gifting concepts. The only regret concerning purchase of self-gifts was evident in the therapeutic and celebratory self-gift motivations. Research limitations/implications A major limitation was the age range specification of 18 to 45 years which meant the omission of older generations of regular and experienced shoppers. This study emphasizes the importance of variations in self-gift behaviors and of post-purchase consumer regret. Originality/value This research is the first examination of an hedonic attitude to shopping and indulgent antecedents to self-gift purchasing, the concepts of self-gift motivations and their effect on post-purchase regret.

Usefulness of a self-reported history of chickenpox in adult women in the Top End

Early determination of immune status is essential for the prevention and/or amelioration of disease following exposure to chickenpox. This is of particular significance for pregnant women because of the additional risks to the foetus or newborn.1 To determine the usefulness of a self-reported history of chickenpox in adult women in the Top End, we compared it with serological evidence of immunity.

Capturing the 'authentic voice' : challenges and opportunities for voice and self-representation in two ABC storytelling projects

In recent years there has been a noticeable move by various public institutions, such as public service broadcasters and community media organisations, to capture and disseminate the voices and viewpoints of ‘ordinary people’ through inviting them to share stories about their lives. One of the foremost objectives of many such projects is to provide under-represented individuals and groups with an opportunity to express and represent themselves; as such, the capture and broadcast of ‘authentic voices’ is a central value. This paper discusses the notion of ‘authentic voice’, and questions the framing role of public media organisations in storytelling projects that aim to provide individuals with space for self-expression and self-representation. It considers the ways in which tensions arise on multiple levels when individuals are asked to express and represent themselves within projects and spaces that are managed by institutions. This paper begins by discussing the challenges and opportunities that arise within storytelling projects that are facilitated by public institutions and community media arts organisations, and that aim to amplify the voices of “ordinary people” (Thumim, 2009). It examines ways in which ‘voice’ is facilitated, curated, broadcast and distributed within such projects, particularly questioning the ways in which project facilitation and the curation of stories for public broadcast can both help and hinder the amplification of ‘authentic voice’. Furthermore, we seek to discuss how ‘authentic voice’ is defined, and what is involved in the process of amplification. The paper moves on to discuss a case study in order to demonstrate some of the tensions that are evident within a storytelling project that is managed by a public institution – Australia’s national broadcaster – and the ways these tensions impact upon the capture and broadcast of an ‘authentic voice’ for project participants. The Australian Broadcasting Corporation’s (ABC) ‘Heywire’ project is a storytelling competition and website that aims to ‘give voice’ to 16-22 year olds who live in rural, regional and remote parts of Australia. Looking at tensions that exist on organisational, political and philosophical levels within the Heywire project reveals a number of conflicts of interest and objectives between the institution and project participants. This leads us to question whether institutionally-managed storytelling projects can effectively support individuals to have an ‘authentic voice’, and whether struggles of aims and objectives diminish the personal benefits that people may derive from expressing and representing themselves within such projects.

Self-Regulated Learning : key strategies and their sources in a sample of adolescent males

This study identified the key self-regulated learning (SRL) strategies and their sources for nine school-aged adolescent males aged 15 to 17 years. The Self-Regulated Learning Interview Schedule (SRLIS) was used along with semi-structured interviews with the participants and their parents to elicit information on SRL strategies and contexts for the formation of self-regulatory habits. Early habit-forming experiences of the family home in relation to homework and study routines were found to form an important base for effective SRL. Teachers were identified as the most common source of SRL strategies with important formative experiences occurring during the first two years of high school.

Curiosity to cupboard : self reported disengagement with energy use feedback over time

This paper discusses findings made during a study of energy use feedback in the home (eco-feedback), well after the novelty has worn off. Contributing towards four important knowledge gaps in the research, we explore eco-feedback over longer time scales, focusing on instances where the feedback was not of lasting benefit to users rather than when it was. Drawing from 23 semi-structured interviews with Australian householders, we found that an initially high level of engagement gave way over time to disinterest, neglect and in certain cases, technical malfunction. Additionally, preconceptions concerned with the “purpose” of the feedback were found to affect use. We propose expanding the scope of enquiry for eco-feedback in several ways, and describe how eco-feedback that better supports decision-making in the “maintenance phase”, i.e. once the initial novelty has worn off, may be key to longer term engagement.

Lesion selection by melanoma high-risk consumers during skin self-examination using mobile teledermoscopy

Mobile teledermatoscopy (MTD) for the early detection of skin cancer uses smartphones with dermatoscope attachments to magnify, capture, and transfer images remotely.1 Using the asymmetry–color variation (AC) rule, consumers achieve dermoscopy sensitivity of 92.9% to 94.0% and specificity of 62.0% to 64.2% for melanoma.2 This pilot randomized trial assessed lesions of concern selected by consumers at high risk of melanoma using MTD plus the AC rule (intervention, n = 10) or the AC rule alone (control, n = 12) during skin self-examination (SSE). Also measured were lesion location patterns, lesions overlooked by participants, provisional clinical diagnoses, likelihood of malignant tumor, and participant pressure to excise lesions.

Scaffolding techniques : a teacher training for cooperative learning in Thailand primary education

Using cooperative learning in classrooms promotes academic achievement, communication skills, problem-solving, social skills and student motivation. Yet it is reported that cooperative learning as a Western educational concept may be ineffective in Asian cultural contexts. The study aims to investigate the utilisation of scaffolding techniques for cooperative learning in Thailand primary mathematics classes. A teacher training program was designed to foster Thai primary school teachers’ cooperative learning implementation. Two teachers participated in this experimental program for one and a half weeks and then implemented cooperative learning strategies in their mathematics classes for six weeks. The data collected from teacher interviews and classroom observations indicates that the difficulty or failure of implementing cooperative learning in Thailand education may not be directly derived from cultural differences. Instead, it does indicate that Thai culture can be constructively merged with cooperative learning through a teacher training program and practices of scaffolding techniques.

Promoting self-determination for better health and wellbeing for adolescents who have an intellectual disability

The focus of this paper is on an Australian research project that evaluated the effectiveness of a resource called the Ask Health Diary, which is used in the school curriculum to promote self-determination for better health and wellbeing for adolescents who have an intellectual disability. Education and health researchers used questionnaires and interviews to gather data from adolescents attending special schools and special education units located in secondary schools in south-east Queensland, their teachers and their parents/carers. This paper reports on two research questions: First, ‘How did the teachers use the Ask Health Diary to promote self-determination in health?’, and second, ‘How did teachers, parents/carers and students perceive the benefits and value of the Ask Health Diary?’ The findings indicate that the Ask Health Diary provides a sound curriculum framework for teachers, adolescents and parents/carers to work together to promote self-determination and better health outcomes for young people who have an intellectual disability.

Not all dimensions of work self-efficacy are equal : understanding the role of tertiary work placements in the development of the elements of work self-efficacy

This paper examines the relationship between a final year tertiary work placement for criminology students at Griffith University in Brisbane and the development of their work self-efficacy. Using a work self-efficacy instrument developed by Professor Joe Raelin at Northeastern University in Boston, a pilot phase in 2006 and a larger study in 2007 investigated the students’ responses across seven self-efficacy factors of learning, problem-solving, teamwork, sensitivity, politics, pressure, and role expectations. Both studies utilised a pre- and post-test and comparisons between these indicated that they believed their abilities to participate constructively in their professional work contexts significantly improved as a result of their placement experience except in the areas of learning, teamwork and sensitivity. This finding will allow us to continue to refine the processes of work placements in order to ensure the integrity of this method for student learning.

Frontier Techniques for Measuring and Estimating Airport Efficiency : An Empirical Review with Practical Guidelines for Analysis and Future Research

Airport efficiency is important because it has a direct impact on customer safety and satisfaction and therefore the financial performance and sustainability of airports, airlines, and affiliated service providers. This is especially so in a world characterized by an increasing volume of both domestic and international air travel, price and other forms of competition between rival airports, airport hubs and airlines, and rapid and sometimes unexpected changes in airline routes and carriers. It also reflects expansion in the number of airports handling regional, national, and international traffic and the growth of complementary airport facilities including industrial, commercial, and retail premises. This has fostered a steadily increasing volume of research aimed at modeling and providing best-practice measures and estimates of airport efficiency using mathematical and econometric frontiers. The purpose of this chapter is to review these various methods as they apply to airports throughout the world. Apart from discussing the strengths and weaknesses of the different approaches and their key findings, the paper also examines the steps faced by researchers as they move through the modeling process in defining airport inputs and outputs and the purported efficiency drivers. Accordingly, the chapter provides guidance to those conducting empirical research on airport efficiency and serves as an aid for aviation regulators and airport operators among others interpreting airport efficiency research outcomes.

Construct design for efficient, effective and high-throughput gene silencing in plants

Post-transcriptional silencing of plant genes using anti-sense or co-suppression constructs usually results in only a modest proportion of silenced individuals. Recent work has demonstrated the potential for constructs encoding self-complementary 'hairpin' RNA (hpRNA) to efficiently silence genes. In this study we examine design rules for efficient gene silencing, in terms of both the proportion of independent transgenic plants showing silencing, and the degree of silencing. Using hpRNA constructs containing sense/anti-sense arms ranging from 98 to 853 nt gave efficient silencing in a wide range of plant species, and inclusion of an intron in these constructs had a consistently enhancing effect. Intron-containing constructs (ihpRNA) generally gave 90-100% of independent transgenic plants showing silencing. The degree of silencing with these constructs was much greater than that obtained using either co-suppression or anti-sense constructs. We have made a generic vector, pHANNIBAL, that allows a simple, single PCR product from a gene of interest to be easily converted into a highly effective ihpRNA silencing construct. We have also created a high-throughput vector, pHELLSGATE, that should facilitate the cloning of gene libraries or large numbers of defined genes, such as those in EST collections, using an in vitro recombinase system. This system may facilitate the large-scale determination and discovery of plant gene functions in the same way as RNAi is being used to examine gene function in Caenorhabditis elegans.