Integrating Poverty and Gender into Health Programmes : a Source Book for Health Professionals : Module on Curricular Integration

Over the past two to three decades, our understanding of poverty has broadened from a narrow focus on income and consumption to a multidimensional notion of education, health, social and political 1 participation, personal security and freedom and environmental quality. Thus, it encompasses not just low income, but lack of access to services, resources and skills; vulnerability; insecurity; and voicelessness and powerlessness. Multidimensional poverty is a determinant of health risks, health seeking behaviour, health care access and health outcomes. As analysis of health outcomes becomes more refined, it is increasingly apparent that the impressive gains in health experienced over recent decades are unevenly distributed. Aggregate indicators, whether at the global, regional or national level, often tend to mask striking variations in health outcomes between men and women, rich and poor, both across and within countries...

Traffic density estimation of signalised arterials with stop line detector and probe data

This research aims to develop a reliable density estimation method for signalised arterials based on cumulative counts from upstream and downstream detectors. In order to overcome counting errors associated with urban arterials with mid-link sinks and sources, CUmulative plots and Probe Integration for Travel timE estimation (CUPRITE) is employed for density estimation. The method, by utilizing probe vehicles’ samples, reduces or cancels the counting inconsistencies when vehicles’ conservation is not satisfied within a section. The method is tested in a controlled environment, and the authors demonstrate the effectiveness of CUPRITE for density estimation in a signalised section, and discuss issues associated with the method.

Expression Profiles of Mitochondrial Genes in the Frontal Cortex and the Caudate Nucleus of Developing Humans and Mice Selectively Bred for High and Low Fear

A growing body of evidence suggests that mitochondrial function may be important in brain development and psychiatric disorders. However, detailed expression profiles of those genes in human brain development and fear-related behavior remain unclear. Using microarray data available from the public domain and the Gene Ontology analysis, we identified the genes and the functional categories associated with chronological age in the prefrontal cortex (PFC) and the caudate nucleus (CN) of psychiatrically normal humans ranging in age from birth to 50 years. Among those, we found that a substantial number of genes in the PFC (115) and the CN (117) are associated with the GO term: mitochondrion (FDR qv <0.05). A greater number of the genes in the PFC (91%) than the genes in the CN (62%) showed a linear increase in expression during postnatal development. Using quantitative PCR, we validated the developmental expression pattern of four genes including monoamine oxidase B (MAOB), NADH dehydrogenase flavoprotein (NDUFV1), mitochondrial uncoupling protein 5 (SLC25A14) and tubulin beta-3 chain (TUBB3). In mice, overall developmental expression pattern of MAOB, SLC25A14 and TUBB3 in the PFC were comparable to the pattern observed in humans (p<0.05). However, mice selectively bred for high fear did not exhibit normal developmental changes of MAOB and TUBB3. These findings suggest that the genes associated with mitochondrial function in the PFC play a significant role in brain development and fear-related behavior.

Moderating teen drinking : combining social marketing and education

Purpose This paper outlines a pilot study that was undertaken in Australia in 2011 that combined social marketing with education. An intervention targeting 14-16 year olds to influence attitudes and behavioural intentions towards moderate drinking was developed and tested. Game On:Know alcohol (GO:KA) is a six-module intervention that is delivered to a year level cohort in an auditorium. GO:KA combines a series of online and offline experiential activities to engage (with) students. Design/methodology Following social marketing benchmark criteria, formative research and competitive analysis were undertaken to create, implement and evaluate an intervention. The intervention was delivered in one all boys' and one all girls' school in April and June 2011, respectively. A total of 223 Year 10 students participated in GO:KA with the majority completing both pre- and post-surveys. Paired samples t-tests and descriptive analysis were used to assess attitudinal and behavioural intention change. Findings Attitudinal change was observed in both schools while behavioural intentions changed for girls and not boys according to paired samples t-testing. Post hoc testing indicated gender differences. Research limitations The lack of a control group is a key limitation of the current research that can be overcome in the 20 school main study to be conducted in 2013-2015. Originality/value The current study provides evidence to suggest that a combined social marketing and education intervention can change teenage attitudes towards moderate drinking whilst only changing behavioural intentions for female teenagers. Analysis of the intervention provides insight into gender differences and highlights the need for a segmented approach.

No right to live? Malaysia’s Islam and implications for its sexual minority storytellers

This paper discusses the fast emerging challenges for Malay and Muslim sexual minority storytellers in the face of an aggressive state-sponsored Islamisation of a constitutionally secular Malaysia. I examine the case of Azwan Ismail, a gay Malay and Muslim Malaysian who took part in the local ‘It Gets Better’ Project, initiated in December 2010 by Seksualiti Merdeka (an annual sexuality rights festival) and who suffered an onslaught of hostile comments from fellow Malay Muslims. In this paper, I ask how a message aimed at discouraging suicidal tendencies among sexual minority teenagers can go so wrong. In discussing the contradictions between Azwan’s constructions of self and the expectations others have of him, I highlight the challenges for Azwan’s existential self. For storytellers who are vulnerable if visible, the inevitable sharing of a personal story with unintended and hostile audiences when placed online, can have significant repercussions. The purist Sunni Islam agenda in Malaysia not only rejects the human rights of the sexual minority in Malaysia but has influenced and is often a leading hostile voice in both regional and international blocs. This self-righteous and supremacist political Islam fosters a more disabling environment for vulnerable, minority communities and their human rights. It creates a harsher reality for the sexual minority that manifests in State-endorsed discrimination, compulsory counselling, forced rehabilitation and their criminalisation. It places the right of the sexual minority to live within such a community in doubt. I draw on existing literature on how personal stories have historically been used to advance human rights. Included too, is the signifance and implications of the work by social psychologists in explaining this loss of credibility of personal stories. I then advance an analytical framework that will allow storytelling as a very individual form of witnessing to reclaim and regain its ‘truth to power’.

On the periodicity of traffic oscillations and capacity drop : the role of driver characteristics

This paper shows that traffic hysteresis, a manifestation of driver characteristics, has a profound impact on the development of traffic oscillations and the bottleneck discharge rate. Findings suggest that aggressive driver behavior (with small response times and jammed spacing) leads to spontaneous formations of stop-and-go disturbances. Furthermore, the aggressive behavior, coupled with a late response to adopt less aggressive behavior, generates large hysteresis that leads to oscillations’ transformation from localized to substantial disturbances and growth. The larger the magnitude of hysteresis is, the larger the growth is. Our finding also suggests that the bottleneck discharge rate can diminish by 8-23% when driver adopts a less aggressive reaction to a disturbance (characterized by a larger response time). This finding is particularly notable since lane-changes have been believed to be the major cause of a reduction in bottleneck discharge rate.

Skin cancer prevention and fashion – frontier bedfellows

Problem Queensland has the highest rates of skin cancer in the world, even after wide-ranging public programs promoting sun safety awareness. To-date, public awareness campaigns on the dangers of excessive sun exposure have been highly successful. For adolescents, however, where a significant amount of lifetime sun exposure occurs, perilous exposure still ensues, despite awareness of the risks. New frontier approaches are required to target this key audience cluster, for this significant national problem. Approach For the majority of adolescents, being part of a collective norm defines their visual, attitudinal and behavioural actions and fashion has been validated as one of the most powerful forces that can form, shape and bolster these norms. Considering clothing is the easiest method to limit the amount of skin exposed to UV, fashion (in its many subtle, yet influential guises) is proposed as an avenue to advance positive sun safe practices for adolescents. Through an action-led methodology, this research explores the potential of fashion, as one of the key parts of a complex equation, to be a prime driver to facilitate sun safety for adolescents. Findings This paper advocates that fashion, as distinguishable from clothing, has the potential to positively influence sun protective behaviour. The findings go further and recommend the use of fashion as a stealth driver for sun safety advancement, for adolescents in particular, via shifts in norms of beauty and targeted generational communication strategies. This frontier approach has the potential to significantly reduce risky sun exposure in adolescence.

Rebuilding in Ranongga : reflecting on practice based research

Two hundred million people are displaced annually due to natural disasters with a further one billion living in inadequate conditions in urban areas. Architects have a responsibility to respond to this statistic as the effects of natural and social disasters become more visibly catastrophic when paired with population rise. The research discussed in this paper initially questions and considers how digital tools can be employed to enhance rebuilding processes, but still achieve sensitive, culturally appropriate and accepted built solutions. Secondly the paper reflects on the impact ‘real-world’ projects have on architectural education. Research aspirations encouraged an atypical ‘research by design’ methodology involving a focused case study in the recently devastated village Keigold, Ranongga, Solomon Islands. Through this qualitative approach specific place data and the accounts of those affected were documented through naturalistic and archival methods of observation and participation. Findings reveal a number of unanticipated results which would have been otherwise undetected if field research within the design and rebuilding process was not undertaken, reflecting the importance of place specific research in the design process. Ultimately, the study proves that it is critical for issues of disaster to be addressed on a local rather than global scale; decisions cannot be speculative, or solved at a distance, but require intensive collaborative work with communities to achieve optimum solutions. Architectural education and design studios would continue to benefit from focused community engagement and field research within the design process.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.

Finding Carpentaria

Invited – and inspired – by Rikki Gunn of GhostNets Australia, in September 2008 sixteen Queensland University of Technology (QUT) design and engineering students and four staff set off on a 2488km journey to spend a fortnight in Karumba on the Gulf of Carpentaria. We went to undertake a strategic planning project we called Linking Karumba, to encourage social, economic, environmental and cultural linkages across the town. During this visit, we and our local project partners realised there should be a second half to the project, in the other Carpentaria Shire town of Normanton, which saw another group of us travelling north again in 2010 to undertake Get EnGulfed: Normanton2020, looking back and forwards to propose strategies to strengthen local and regional identities. The responsiveness of our students’ work to the character of Carpentarian culture and environment indicate remarkable levels of immersion, and the community expressed their enjoyment of the process and outcomes. As for us - QUT staff and students - we had a marvellous time doing these projects, and this little book is the story of our finding of the landscapes and communities of Carpentaria “where the outback meets the sea”, and of the project work we did together with locals in the two towns. We go to press as news arrives of the official opening of the Karumba Walking track, linking the two parts of the town. We can’t wait to return and make the walk. Shannon Satherley, 2013

Make-Buy Decisions in the Face of Radical Innovations

Make-buy decisions are an important aspect of the overall strategic plans for most firms, and the introduction of a new and potentially radical technology into an industry should therefore be a cue for managers to review their make-buy policies. Should a company make in-house the components and processes underpinning the technology, or should it buy them from an outside supplier? Earlier attempts to answer this question may have failed to agree on a single verdict because they have overlooked two important market forces: supplier relations and industry clockspeed. Based on an intensive three-year study at the University of Cambridge which analyzed supply chain management practices from a broad range of manufacturers around the world, this book helps to resolve this classic technology outsourcing dilemma and gives managers the tools they will need to determine if they should make or buy the components and processes that go into a potentially radical innovation.

How does innovation happen in the upstream oil & gas industry? Insights from a global survey

Few would argue that the upstream oil & gas industry has become more technology-intensive over the years. But how does innovation happen in the industry? Specifically, what ideas and inputs flow from which parts of the sector’s value network, and where do these inputs go? And how do firms and organizations from different countries contribute differently to this process? This paper puts forward the results of a survey designed to shed light on these issues. A joint research initiative between the Society of Petroleum Engineers and the Queensland University of Technology, the survey was sent to 469 executives and senior managers who played a significant role with regards to R&D and/or technology deployment in their respective business units. A total of 199 responses were received from a broad range of organizations and countries around the world. Several interesting themes and trends emerge from the results, including: (1) service companies tend to file considerably more patents per innovation than other types of organization; (2) over 63% of the deployed innovations reported in the survey originated in service companies; (3) neither universities nor government-led research organizations are considered to be valuable sources of new information and knowledge in the industry’s R&D initiatives; and (4) despite the increasing degree of globalization in the marketplace, the USA still plays an extremely dominant role in the industry’s overall R&D and technology deployment activities. By providing a detailed snapshot of how innovation happens in the upstream oil & gas sector, this paper provides a valuable foundation for future investigations and discussions aimed at improving how R&D and technology deployment are managed within the industry.

The Effective and The Evocative : A Spectrum of Creative Practice Research

In the expanding literature on creative practice research, art and design are often described as a unified field. They are bracketed together (art-and-design), referred to as interchangeable terms (art/design), and nested together, as if the practices of one domain encompass the other. However it is possible to establish substantial differences in research approaches. In this chapter we argue that core distinctions arise out of the goals of the research, intentions invested in the resulting “artefacts” (creative works, products, events), and the knowledge claims made for the research outcomes. Moreover, these fundamental differences give rise to a number of contingent attributes of the research such as the forming contexts, methodological approaches, and ways of evidencing and reporting new knowledge. We do not strictly ascribe these differences to disciplinary contexts. Rather, we use the terms effective practice research and evocative practice research to describe the spirit of the two distinctive research paradigms we identify. In short, effective practice research (often pursued in design fields) seeks a solution (or resolution) to a problem identified with a particular community, and it produces an artefact that addresses this problem by effecting change (making a situation, product or process more efficient or effective in some way). On the other hand, evocative practice research (often pursued by creative arts fields) is driven by individual pre-occupations, cultural concerns or human experience more broadly. It produces artefacts that evoke affect and resonance, and are poetically irreducible in meaning. We cite recent examples of creative research projects that illustrate the distinctions we identify. We then go on to describe projects that integrate these modes of research. In this way, we map out a creative research spectrum, with distinct poles as well as multiple hybrid possibilities. The hybrid projects we reference are not presented as evidence an undifferentiated field. Instead, we argue that they integrate research modes in deliberate, purposeful and distinctive ways: employing effective practice research methods in the production of evocative artefacts or harnessing evocative (as well as effective) research paradigms to effect change.

Rich and purposeful mathematical knowledge of mothers and children in a Torres Strait Islander community

This paper focuses on a pilot study that explored the situated mathematical knowledge of mothers and children in one Torres Strait Islander community in Australia. The community encouraged parental involvement in their children’s learning and schooling. The study explored parents’ understandings of mathematics and how their children came to learn about it on the island. A funds of knowledge approach was used in the study. This approach is based on the premise that people are competent and have knowledge that has been historically and culturally accumulated into a body of knowledge and skills essential for their functioning and well-being (Moll, 1992). The participants, three adults and one child are featured in this paper. Three separate events are described with epiphanic or illuminative moments analysed to ascertain the features that enabled an understanding of the nature of the mathematical events. The study found that Indigenous ways of knowing of mathematics were deeply embedded in rich cultural practices that were tied to the community. This finding has implications for teachers of children in the early years. Where school mathematics is often presented as disembodied and isolated facts with children seeing little relevance, learning a different perspective of mathematics that is tied to the resources and practices of children’s lives and facilitated through social relationships, may go a long way to improving the engagement of children and their parents in learning and schooling.

Facilitating local stories in post-disaster regional communities : evaluation in narrative-driven oral history projects

Cyclone Yasi struck the Cassowary Coast of Northern Queensland, Australia, in the early hours of February 3, 2011, destroying many homes and property, including the destruction of the Cardwell and district historical society’s premises. With their own homes flattened, many residents were forced to live in mobile accommodation, with extended family, or leave the area altogether. The historical society members seemed, however, particularly devastated by their flattened foreshore museum and loss of their precious collection of material. A call for assistance was made through the Oral History Association of Australia’s Queensland branch (OHAA Qld), which along with a Queensland University of Technology (QUT) research team sponsored a trip to best plan how they could start to pick up the pieces to rebuild the museum. This chapter highlights the need for communities to gather, preserve and present their own stories, in a way that is sustainable and meaningful to them – whether that be because of a disaster, or as they go about life in their contemporary communities – the key being that good advice, professional support and embedded evaluation practices at crucial moments along the way can be critically important.