Reliability and validity of a brief physical activity assessment for use by family doctors

Objective: To evaluate the reliability and validity of a brief physical activity assessment tool suitable for doctors to use to identify inactive patients in the primary care setting. Methods: Volunteer family doctors (n = 8) screened consenting patients (n = 75) for physical activity participation using a brief physical activity assessment tool. Inter-rater reliability was assessed within one week (n = 71). Validity was assessed against an objective physical activity monitor (computer science and applications accelerometer; n = 42). Results: The brief physical activity assessment tool produced repeatable estimates of sufficient total physical activity, correctly classifying over 76% of cases (kappa 0.53, 95% confidence interval (CI) 0.33 to 0.72). The validity coefficient was reasonable (kappa 0.40, 95% CI 0.12 to 0.69), with good percentage agreement (71%). Conclusions: The brief physical activity assessment tool is a reliable instrument, with validity similar to that of more detailed self report measures of physical activity. It is a tool that can be used efficiently in routine primary healthcare services to identify insufficiently active patients who may need physical activity advice.

Perceptions of the influence of prescription medicine samples on prescribing by family physicians

Background: The provision of free prescription medicine samples is a common and traditional marketing strategy used by pharmaceutical companies, but concerns have been raised about their influence on physician prescribing behavior and patient safety. Objective: We sought to investigate the knowledge, attitudes, and behaviors of Australian family physicians regarding the use of sample prescription medications. Methods: Qualitative and quantitative techniques were used, including (1) mailed questionnaires to family physicians, (2) semistructured interviews with family physicians, and (3) sample cupboard inventories. Results: A number of issues about samples were identified by the questionnaires (208) and interviews (17 doctors), including insufficient labeling, poor record keeping, diversion of stock (personal use by doctors.. their families, practice staff and pharmaceutical representatives), and wasting of expired stock. Prescription medicine samples also influenced prescribing behavior. Australian doctors were less likely to provide samples to patients on financial grounds compared with a previous study in the United States on medical residents. Six sample cupboards were inventoried. Median wholesale value of sample cupboards was AUD $4959 (range $2395-$8709), with 6% of stock expired. Very little generic medicine was included in the sample cupboards. Conclusions: Better methods are needed to meet legislative requirements and to ensure quality use of medicines (and optimal public health) with respect to prescription medicine samples. Doctors and practice staff require training on the appropriate handling and storage of prescription medications. Alternative ways for distribution of sample medications need to be investigated.

Interagency collaboration between child protection and mental health services: Practices, attitudes and barriers

Objective: The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and experiences, and barriers to effective collaboration. Method: A self-administered, cross-sectional survey was developed and distributed via direct mail or via line supervisors to workers in statutory child protection services, adult mental health services, child and youth mental health services, and Suspected Child Abuse and Neglect (SCAN) Teams. There were 232 completed questionnaires returned, with an overall response rate of 21%. Thirty-eight percent of respondents were statutory child protection workers. 39% were adult mental health workers, 16% were child and youth mental health workers, and 4% were SCAN Team medical officers (with 3% missing data). Results: Analysis revealed that workers were engaging in a moderate amount of interagency contact, but that they were unhappy with the support provided by their agency. Principle components analysis and multivariate analysis of variance (MANOVA) on items assessing attitudes toward other workers identified four factors, which differed in rates of endorsement: inadequate training, positive regard for child protection workers, positive regard for mental health workers, and mutual mistrust (from highest to lowest level of endorsement). The same procedure identified the relative endorsement of five factors extracted from items about potential barriers: inadequate resources, confidentiality, gaps in interagency processes, unrealistic expectations, and professional knowledge domains and boundaries. Conclusions: Mental health and child protection professionals believe that collaborative practice is necessary; however, their efforts are hindered by a lack of supportive structures and practices at the organizational level. (c) 2005 Published by Elsevier Ltd.

Sustainable tourism planning: A content analysis of local tourism plans

Tourism planning has been advocated by many as a possible means of alleviating some of the negative impacts of tourism. While a number of approaches have evolved, tourism planning based on the philosophies of sustainability has emerged as the most comprehensive approaches. To investigate the tourism planning approaches of local tourism destinations in Queensland, particularly the extent to which tourism plans exhibit the sustainable approach to tourism planning, 30 local tourism planning documents have been reviewed. Despite claims that sustainable tourism planning is one of the most accepted approaches the study has shown that this is not necessarily the case in practice. It was found that although a number of plans addressed the issue of sustainability, the subsequent strategies and actions suggest that the sustainable approach is not the dominant planning approach, but in fact the economic and infrastructure approaches are the primary planning methods.

Achieving key dimensions of sustainability: Strategic visioning as a tourism destination planning tool

Tourism has had, and is continuing to have, a profound impact upon destinations, economically, environmentally and socially. The negative impacts of tourism have been attributed, among other things, to inadequate or non-existent planning frameworks for tourism development, and it has therefore been advocated that tourism planning is vital to offset some of these negative impacts. While several different approaches have been supported over the years, tourism planning based on the philosophies of sustainability has emerged as one ofthe most comprehensive approaches. However, two critical concepts have been identified as precursors to sustainable development: a strategic Qrientation towards tourism planning and enhanced levels of multiple stakeholder participation in the tourism planning process (Simpson 2001 ). While both strategic tourism planning and stakeholder participation and collaboration, have received considerable attention in the academic literature, there has been relatively little written about its practical application. However, the somewhat recent emergence of the strategic visioning concept as a destination planning tool may provide the necessary practical framework for incorporating stakeholder collaboration into destination strategic planning and management. This paper will provide a synthesis of the stakeholder collaboration, strategic planning and strategic visioning literatures, before conceptually examining the potential applicability._ of the strategic visioning process in achieving meaningful stakeholder participation and collaboration in destination planning.

Information system planning in drug service:a case study

The development of an information system in Caribbean public sector organisations is usually seen as a matter of installing hardware and software according to a directive from senior management, without much planning. This causes huge investment in procuring hardware and software without improving overall system performance. Increasingly, Caribbean organisations are looking for assurances on information system performance before making investment decisions not only to satisfy the funding agencies, but also to be competitive in this dynamic and global business world. This study demonstrates an information system planning approach using a process-reengineering framework. Firstly, the stakeholders for the business functions are identified along with their relationships and requirements. Secondly, process reengineering is carried out to develop the system requirements. Accordingly, information technology is selected through detailed system requirement analysis. Thirdly, cost-benefit analysis, identification of critical success factors and risk analysis are carried out to strengthen the selection. The entire methodology has been demonstrated through an information system project in the Barbados drug service, a public sector organisation in the Caribbean.

Managing enterprise resource planning projects

Purpose – The purpose of this paper is to help managers to successfully plan, implement, and operate enterprise resource planning (ERP) projects using a risk management framework. Design/methodology/approach – This paper adopted a combined literature review and case study method. Using literature review, the paper first identified major issues of managing ERP projects and develops a risk management framework for managing those issues. The proposed risk management framework was then applied to a ERP implementation project of a UK-based energy services group and its effectiveness for managing ERP projects implementation had been demonstrated. Additionally, the risk factors as identified from the case application are compared with the risk factors from the previous researches so as to suggest mitigating measures. Findings – All the risk factors are categorized into planning, implementation and operations phases along with project processes, organizational transformation and information technology (IT) perspectives. Project implementation phase is the most vulnerable to failure. The case study results reveal that the effect of other projects on on-going ERP project, management of overall IT architecture and non-availability of resources for organizational transformation are most critical from likelihood and impact perspectives. Managing risk across various phases of project and equal emphasize to effective project management, organizational transformation and IT adoption are the key to success in ERP implementation. Practical implications – The risk factors, which were identified using literature review and the case study, have great significance as mitigating measures of those risks may result successful implementation of ERP projects in the industry. Additionally, proposed risk management framework could be customized to implement ERP projects elsewhere. Originality/value – ERP projects are risky as they are capital intensive, technically complex, and call for organizational transformation. There are both success and failure stories. However, both researchers and practitioners agree, that if it can be implemented and operated successfully and benefits should be achievable. Although there are many studies on ERP implementation, little has been discussed on managing risks of ERP projects. Therefore, this paper bridges the gap.

A study of national physical planning policy

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