A model for assessing and correcting project Health

Maintaining the health of a construction project can help to achieve the desired outcomes of the project. An analogy is drawn to the medical process of a human health check where it is possible to broadly diagnose health in terms of a number of key areas such as blood pressure or cholesterol level. Similarly it appears possible to diagnose the current health of a construction project in terms of a number of Critical Success Factors (CSFs) and key performance indicators (KPIs). The medical analogy continues into the detailed investigation phase where a number of contributing factors are evaluated to identify possible causes of ill health and through the identification of potential remedies to return the project to the desired level of health. This paper presents the development of a model that diagnoses the immediate health of a construction project, investigates the factors which appear to be causing the ill health and proposes a remedy to return the project to good health. The proposed model uses the well-established continuous improvement management model (Deming, 1986) to adapt the process of human physical health checking to construction project health.

How the whiteness embedded in health services impacts on the health and well-being of Aboriginal peoples

Aboriginal women are treated differently by non-indigenous health care providers based on perceptions of Aboriginality and skin colour and white race privilege within health care environments. The experiences shared below are from some of the Aboriginal woman respondents in a research project undertaken within Rockhampton, a regional area in Central Queensland (Fredericks, 2003). The experiences give an insight into how the Aboriginal women interviewed felt and their observations of how other Aboriginal women were treated within health care settings based on skin colour and perceptions of Aboriginality. A number of the women demonstrated a personal in-depth analysis of the issues surrounding place, skin colour and Aboriginality. For example, one of the women, who I named Kay, identified one particular health service organisation and stated that, ‘it is a totally white designed space. There is nothing that identifies me to that place. I just won’t go there as a client because I don’t feel they cater for me as a black woman’. Kay’s words give us an understanding of the reality experienced by Aboriginal women as they move in and out of places within health environments and broader society. Some of these experiences are examples of direct racism, whilst other examples are subtle and demonstrate how whiteness manifests and plays out within places. I offer acknowledgement and honour to the Aboriginal women who shared their stories and gave me a glimpse of their realities in the research project from which the findings presented in this chapter are taken. It is to this research project that is the subject of this chapter.

There is nothing that 'identifies me to that place' : Aboriginal Women's perceptions of health spaces and places

There is a growing body of literature within social and cultural geography that explores notions of place, space, culture, race and identity. The more recent works suggest that places are experienced and understood in multiple ways and are embedded within an array of politics. Memmott and Long, who have undertaken place-based research with Australian Indigenous people, present the theoretical position that ‘place is made and takes on meaning through an interaction process involving mutual accommodation between people and the environment’. They outline that places and their cultural meanings are generated through one or a combination of three types of people–environment interactions. These include: a place that is created by altering the physical characteristics of a piece of environment and which might encompass a feature or features which are natural or made; a place that is created totally through behaviour that is carried out within a specific area, therefore that specific behaviour becomes connected to that specific place; and a place created by people moving or being moved from one environment to another and establishing a new place where boundaries are created and activities carried out. All these ideas of places are challenged and confirmed by what Indigenous women have said about their particular use of, and relationship with, space within several health services in Rockhampton, Central Queensland. As my title suggests, Indigenous women do not see themselves as ‘neutral’ or ‘non-racialised’ citizens who enter and ‘use’ a supposedly neutral health service. Instead, Aboriginal women demonstrate they are active recognisers of places that would identify them within the particular health place. That is, they as Aboriginal women didn’t just ‘make’ place, the places and spaces ‘make’ them. The health services were identified as sites within which spatial relations could begin to grow with recognition of themselves as Aboriginal women in place, or instead create a sense of marginality in the failure of the spaces to identify them. The women’s voices within this paper are drawn from interviews undertaken with twenty Aboriginal women in Rockhampton, Central Queensland, Australia, who participated in a research project exploring ‘how the relationship between health services and Aboriginal women can be more empowering from the viewpoints of Aboriginal women’. The assumption underpinning this study was that empowering and re-empowering practices for Aboriginal women can lead to improved health outcomes. Throughout the interviews women shared some of their lived realities including some of their thoughts on identity, the body, employment in the health sector, service delivery and their notions of health service spaces and places. Their thoughts on health service spaces and places provide an understanding of the lived reality for Aboriginal women and are explored and incorporated within this paper.

PEPA workshops for allied health professionals : outcomes and directions for the future

The Program of Experience in the Palliative Approach (PEPA) started in 2003 as an initiative of the Australian Government, Department of Health and Ageing. The overall aim of PEPA is to improve the quality, availability and access to palliative care for people who are dying, and their families, by providing high quality learning experiences for primary care providers, including allied health professionals. As part of the program, an allied health workshop program has been developed following an extensive review of the literature and in consultation with experts in the field. The PEPA allied health workshops are offered across all states/territories.

The research pathway to developing a health promotion intervention for the high school curriculum

Introduction: Schools provide the opportunity to reach a large number of adolescents in a systematic way however there are increasing demands on curriculum providing challenges for health promotion activities. This paper will describe the research processes and strategies used to design an injury prevention program.----- Methods: A multi-stage process of data collection included: (1) Surveys on injury-risk behaviours to identify targets of change (examining behaviour and risk/ protective factors among more than 4000 adolescents); (2) Focus groups (n= 30 high-risk adolescents) to understand and determine risk situations; (3) Hospital emergency outpatients survey to understand injury types/ situations; (4) Workshop (n= 50 teachers/ administrators) to understand the target curriculum and experiences with injury-risk behaviours; (5) Additional focus groups (students and teachers) regarding draft material and processes.----- Results: Summaries of findings from each stage are presented particularly demonstrating the design process. The baseline data identified target risk and protective factors. The following qualitative study provided detail about content and context and with the hospital findings assisted in developing ways to ensure relevance and meaning (e.g. identifying high risk situations and providing insights into language, culture and development). School staff identified links to school processes with final data providing feedback on curriculum fit, feasibility and appropriateness of resources. The data were integrated into a program which demonstrated reduced injury.----- Conclusions: A comprehensive research process is required to develop an informed and effective intervention. The next stage of a cluster randomised control trial is a major task and justifies the intensive and comprehensive development.

The new world of work and employment: fitness workers and what they want from the employment relationship

This paper reports on an empirically based study of the Queensland (Australia) health and fitness industry over 15 years (1993 -2008). This study traces the development of the new occupation of fitness instructor in a service industry which has evolved si nce the 1980s and is embedded in values of consumption and individualism. It is the new world of work. The data from the 1993 study was historically significant, capturing the conditions o f employment in an unregulated setting prior to the introduction of the first industrial a ward in that industry in 1994. Fitness workers bargained directly with employers over all a spects of the employment relationship without the constraints of industrial regulation or the presence of trade unions. The substantive outcomes of the employment relationship were a direct reflection of m anagerial prerogative and worker orientation and preference, and did not reflect the rewards and outcomes traditionally found in Australian workplaces. While the focus of the 1993 research was on exploring the employment relationship in a deregulated environment, an unusual phenomenon was identified: fitness workers happily trading-off what would be considere d standard working conditions for the opportunity to work (‘take the stage’). Since then, several streams of literature have evolved providing a new context for understanding this phenomenon in the fitness industry, including: the sociology of the body (Shilling 1993; Turner 1996); emotional (Hochschild 1984) and aesthetic labour (Warhurst et al 2000); the so cial relations of production and space (Lefebvre 1991; Moss 1995); body history (Helps 2007); the sociology of consumption (Saunders 1988; Baudrillard 1998; Ritzer 2004); and work identity (Du Gay 1996; Strangleman 2004). The 2008 survey instrument replicated the 1993 study but was additionally informed b y the new literature. Surveys were sent to 310 commercial fitness centres and 4,800 fitness workers across Queensland. Worker orientation appears unchanged, and industry working conditions still seem atypical despite regulation si nce 1994. We argue that for many fitness workers the goal is to gain access to the fitness centre economy. For this they are willing to trade-off standard conditions of employment, and exchange traditional employm ent rewards for m ore intrinsic psycho-social rewards gained the through e xp o sure of their physical capital (Bourdieu 1984) o r bo dily prowess to the adoration o f their gazing clients. Building on the tradition of emotional labour and aesthetic labour, this study introduces the concept of ocularcentric labour: a state in which labour’s quest for the psychosocial rewards gained from their own body image shapes the employment relationship. With ocularcentric labour the p sycho-social rewards have greater value for the worker than ‘hard’, core conditions of employment, and are a significant factor in bargaining and outcomes, often substituting fo r direct earnings. The wo rkforce profile (young, female, casual) and their expectations (psycho-social rewards of ado ration and celebrity) challenge traditional trade unions in terms of what they can deliver, given the fitness workers’ willingness to trade-off minimum conditions, hard-won by unions.

A longitudinal study of motivation and competence in children with Down syndrome : early childhood to early adolescence

Background Motivation has been identified as an area of difficulty for children with Down syndrome. Although individual differences in mastery motivation are presumed to have implications for subsequent competence, few longitudinal studies have addressed the stability of motivation and the predictive validity of early measures for later academic achievement, especially in atypical populations. Method The participants were 25 children with Down syndrome. Mastery motivation, operationalised as persistence, was measured in early childhood and adolescence using tasks and parent report. At the older age, preference for challenge, another aspect of mastery motivation, was also measured and the children completed assessments of academic competence. Results There were significant concurrent correlations among measures of persistence at both ages, and early task persistence was associated with later persistence. Persistence in early childhood was related to academic competence in adolescence, even when the effects of cognitive ability at the younger age were controlled. Conclusions For children with Down syndrome, persistence appears to be an individual characteristic that is relatively stable from early childhood to early adolescence. The finding that early mastery motivation is significant for later achievement has important implications for the focus of early interventions.

Source location of acoustic emission waves for structural health monitoring of bridges

The process of structural health monitoring (SHM) involves monitoring a structure over a period of time using appropriate sensors, extracting damage sensitive features from the measurements made by the sensors and analysing these features to determine the current state of the structure. Various techniques are available for structural health monitoring of structures and acoustic emission (AE) is one technique that is finding an increasing use. Acoustic emission waves are the stress waves generated by the mechanical deformation of materials. AE waves produced inside a structure can be recorded by means of sensors attached on the surface. Analysis of these recorded signals can locate and assess the extent of damage. This paper describes preliminary studies on the application of AE technique for health monitoring of bridge structures. Crack initiation or structural damage will result in wave propagation in solid and this can take place in various forms. Propagation of these waves is likely to be affected by the dimensions, surface properties and shape of the specimen. This, in turn, will affect source localization. Various laboratory test results will be presented on source localization, using pencil lead break tests. The results from the tests can be expected to aid in enhancement of knowledge of acoustic emission process and development of effective bridge structure diagnostics system.

Incorporating an economic model in the health impact assessment approach

The current policy decision making in Australia regarding non-health public investments (for example, transport/housing/social welfare programmes) does not quantify health benefits and costs systematically. To address this knowledge gap, this study proposes an economic model for quantifying health impacts of public policies in terms of dollar value. The intention is to enable policy-makers in conducting economic evaluation of health effects of non-health policies and in implementing policies those reduce health inequalities as well as enhance positive health gains of the target population. Health Impact Assessment (HIA) provides an appropriate framework for this study since HIA assesses the beneficial and adverse effects of a programme/policy on public health and on health inequalities through the distribution of those effects. However, HIA usually tries to influence the decision making process using its scientific findings, mostly epidemiological and toxicological evidence. In reality, this evidence can not establish causal links between policy and health impacts since it can not explain how an individual or a community reacts to changing circumstances. The proposed economic model addresses this health-policy linkage using a consumer choice approach that can explain changes in group and individual behaviour in a given economic set up. The economic model suggested in this paper links epidemiological findings with economic analysis to estimate the health costs and benefits of public investment policies. That is, estimating dollar impacts when health status of the exposed population group changes by public programmes – for example, transport initiatives to reduce congestion by building new roads/ highways/ tunnels etc. or by imposing congestion taxes. For policy evaluation purposes, the model is incorporated in the HIA framework by establishing association among identified factors, which drive changes in the behaviour of target population group and in turn, in the health outcomes. The economic variables identified to estimate the health inequality and health costs are levels of income, unemployment, education, age groups, disadvantaged population groups, mortality/morbidity etc. However, though the model validation using case studies and/or available database from Australian non-health policy (say, transport) arena is in the future tasks agenda, it is beyond the scope of this current paper.

From surfboard wax to salient health inequity : School programs to develop globally aware and active citizens

During the past century, significant improvements in the prevention, detection and treatment of infectious disease have positively impacted upon quality and quantity of life for many people worldwide. Despite this progress, there are large numbers of people currently living in developing regions of the world where infectious disease continues unabated. SurfAid International is a humanitarian organisation that has brought significant health improvements to the people living on the Mentawai and Nias islands of Indonesia. The SurfAid International Schools Program aims to develop global citizenship and social responsibility by providing a bridge between school settings and the critical work of SurfAid International. This paper provides a rationale for the development of contextualised school based programs and identifies potential impact upon the thoughts and actions of young people in schools.

Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Environmental and public health issues in Mount Isa : 2007 community survey

This report presents the results of a random telephone survey of 500 adult residents of Mount Isa, conducted in early November 2007. The study was funded by Xstrata Mount Isa Mines. The primary aim of the survey was to collect data about community perceptions and experiences of air quality in Mount Isa and to compare these results with those of a similar survey conducted in 2000 (MacLennan, Lloyd & Hensley, 2000). Both surveys also included questions relating to other aspects of the Mount Isa environment (e.g. water quality, heat, amount of greenery) as well as questions aimed at ascertaining respondents’ general attitudes towards environmental protection.

Health outcomes of adults 3 months after injury

Background: Injury is a leading cause of preventable mortality and morbidity in Australia and the world. Despite this there is little research examining the health related quality of life of adults following general trauma. Methods: A prospective cohort design was used to study adults who presented to hospital following injury. Data regarding injury and demographic details was collected through the routine operation of the Queensland Trauma Registry (QTR). In addition, the short form 36 (SF-36) was mailed to patients approximately 3 months following injury. Results: Participants included 339 injured patients who were hospitalised for ≥24 h in March-June 2003. A secondary group of 145 patients completed the SF-36, but did not have QTR data collected due to hospitalisation being <24 h. Both groups of participants reported significantly lower scores on all subscales of the SF-36 when compared to Australian norms. Conclusions: Health related quality of life of injured survivors is markedly reduced 3 months after injury. Ongoing treatment and support is necessary to improve these health outcomes.

Prognosis of bearing failure based on health state estimation

This paper proposes a new prognosis model based on the technique for health state estimation of machines for accurate assessment of the remnant life. For the evaluation of health stages of machines, the Support Vector Machine (SVM) classifier was employed to obtain the probability of each health state. Two case studies involving bearing failures were used to validate the proposed model. Simulated bearing failure data and experimental data from an accelerated bearing test rig were used to train and test the model. The result obtained is very encouraging and shows that the proposed prognostic model produces promising results and has the potential to be used as an estimation tool for machine remnant life prediction.