Family planning amongst the Akha & Khmu : "what type of services is necessary?" : Khua District, Lao PDR : a dissertation presented in partial fulfillment of the requirements for a Masters of Philosophy in Development Studies at Massey University, Palmerston North, New Zealand

The Lao PDR, a landlocked country, of 236 800 sq kms, with a population of 5,091,100, is situated between Thailand and Cambodia to the south, Vietnam to the east. China to the north, and Myanmar to the west. Lao is a geographically diverse country, which stretches along the Annamite chain to the Mekong River valley. There are 48 ethnic groups in the Lao PDR. The majority of which make up the Lao Loum (lowland Lao). Lao is one of the few remaining communist countries in the world today. Following the people's revolution in 1975 the Lao PDR was formed by the Lao Peoples Revolutionary Party, which currently remains the only political party in existence in the Lao PDR. Today the Party remains strong with a centralised government, though through a series of political reforms during the 1980s such as the introduction of the New Economic Mechanism the country has opened up to more international trade and investment. Entry into the World Trade Organisation (WTO) is now being considered following a submission made in 2000. The reproductive health of women in the Lao PDR is one of the top ten priorities of the Ministry of Health's Primary Health Care Policy. To assist with the implementation of the policy a National Family planning Program was established in 1991. While initial implementation of the program focussed on more densely populated areas in the more accessible provincial capitals along the Mekong River, women in remote rural communities are also being targeted. While the policy is to be commended for its aims, the implementation of activities to achieve its aims can at times be hindered by a lack of funding, poor infrastructure and communication and a lack of human resources. [FROM INTRODUCTION

Primary goals, information-giving and men\u27s understanding: A qualitative study of Australian and UK doctors\u27 varied communication about PSA screening

Objectives: (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary. Study design and setting: A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29). Results: GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach. Conclusion: GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardized in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions

Relational conceptions of paternalism : a way to rebut nanny-state accusations and evaluate public health interventions

This work is funded by NHMRC grant 1023197. Stacy Carter is funded by an NHMRC Career Development Fellowship 1032963. Acknowledgements An early version of this work was presented at a workshop on paternalism held on Friday 8 November 2013 at the Centre for Agency, Values and Ethics at Macquarie University. We thank participants in that workshop for their helpful comments. Thanks also to Prof Catriona Mackenzie for her helpful comments on an earlier draft of this manuscript and to Prof Paul Benson for providing us with an early version of his work on stereotype threat.Peer reviewedPostprintPostprin

Relational conceptions of paternalism: a way to rebut nanny-state accusations and evaluate public health interventions

Objectives: ‘Nanny-state’ accusations can function as powerful rhetorical weapons against interventions intended to promote public health. Public health advocates often lack effective rebuttals to these criticisms. Nanny-state accusations are largely accusations of paternalism. They conjure up emotive concern about undue governmental interference undermining peoples’ autonomy. But autonomy can be understood in various ways. We outline three main conceptions of autonomy, argue that these that can underpin three different conceptions of paternalism, and consider implications for responses to nanny-state accusations and the assessment of public health interventions. Study design and methods: Detailed conceptual analysis. Results: The conceptions of paternalism implicit in nanny-state accusations generally depend on libertarian conceptions of autonomy. These reflect unrealistic views of personal independence and do not discriminate sufficiently between trivial and important freedoms. Decisional conceptions of paternalism, like their underlying decisional conceptions of autonomy, have limited applicability in public health contexts. Relational conceptions of paternalism incorporate relational conceptions of autonomy, so recognise that personal autonomy depends on socially shaped skills, self-identities and self-evaluations as well as externally structured opportunities. They encourage attention to the various ways that social interactions and relationships, including disrespect, stigmatisation and oppression, can undermine potential for autonomy. While nanny-state accusations target any interference with negative freedom, however trivial, relational conceptions direct concerns to those infringements of negative freedom, or absences of positive freedom, serious enough to undermine self-determination, self-governance and/or self-authorisation. Conclusion: Relational conceptions of autonomy and paternalism offer public health policymakers and practitioners a means for rebutting nanny-state accusations, and can support more nuanced and more appropriately demanding appraisals of public health interventions. (249 words) Keywords: Paternalism; autonomy; nanny-state; public health; ethicsThis work is funded by NHMRC grant 1023197. Stacy Carter is funded by an NHMRC Career Development Fellowship 103296

Exact nonadiabatic part of the Kohn-Sham potential and its fluidic approximation

We present a simple geometrical "fluidic" approximation to the nonadiabatic part of the Kohn-Sham potential, vKS, of time-dependent density-functional theory (DFT). This part of vKS is often crucial, but most practical functionals utilize an adiabatic approach based on ground-state DFT, limiting their accuracy in many situations. For a variety of model systems, we calculate the exact time-dependent electron density and find that the fluidic approximation corrects a large part of the error arising from the "exact adiabatic" approach, even when the system is evolving far from adiabatically

Chapter 22 FEMINIST BIOETHICS AND EMPIRICAL RESEARCH

The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising forty-two chapters by emerging and established scholars, the volume is divided into six parts: I Foundations of feminist bioethics II Identity and identifications III Science, technology and research IV Health and social care V Reproduction and making families VI Widening the scope of feminist bioethics The volume is essential reading for anyone with an interest in bioethics or feminist philosophy, and will prove an invaluable resource for scholars, teachers and advanced students

Approaches to study in higher education portuguese students: a portuguese version of the Approaches and Study Skills Inventory for Students (ASSIST)

This paper examines the validity of the Approaches and Study Skills Inventory for Students—short version (ASSIST; Tait et al. in Improving student learning: Improving students as learners, 1998), to be used with Portuguese undergraduate students. The ASSIST was administrated to 566 students, in order to analyse a Portuguese version of this inventory. Exploratory factor analysis (principal axis factor analysis followed by direct oblimin rotation) reproduced the three main factors that correspond to the original dimensions of the inventory (deep, surface apathetic and strategic approaches to learning). The results are consistent with the background theory on approaches to learning. Additionally, the reliability analysis revealed acceptable internal consistency indexes for the main scales and subscales. This inventory might represent a valuable research tool for the assessment of approaches to learning among Portuguese higher education students

Risk, Overdiagnosis and Ethical Justifications

Wendy Rogers was supported by Future Fellowship (FT130100346) from the Australian Research Council and a 2018 Residency from the Brocher Foundation. Stacy Carter was supported by National Health and Medical Research Council Centre for Research Excellence 1104136 and a 2018 Residence from the Brocher Foundation. This study was funded by FT130100346 from the Australian Research Council (Rogers) and CRE 1104136 from the National Health and Medical Research Council (Carter), and Rogers and Carter both received support in the form of a 2018 month-long residency at the Brocher Foundation, Switzerland.Peer reviewedPublisher PD

Supporting the learning of deaf students in higher education: a case study at Sheffield Hallam University

This article is an examination of the issues surrounding support for the learning of deaf students in higher education (HE). There are an increasing number of deaf students attending HE institutes, and as such provision of support mechanisms for these students is not only necessary but essential. Deaf students are similar to their hearing peers, in that they will approach their learning and require differing levels of support dependant upon the individual. They will, however, require a different kind of support, which can be technical or human resource based. This article examines the issues that surround supporting deaf students in HE with use of a case study of provision at Sheffield Hallam University (SHU), during the academic year 1994-95. It is evident that by considering the needs of deaf students and making changes to our teaching practices that all students can benefit