Physical and environmental determinants

This chapter describes physical and environmental determinants of the health of Australians, providing a background to the development of successful public health activity. Health determinants are the biomedical, genetic, behavioural, socio-economic and environmental factors that impact on health and wellbeing. These determinants can be influenced by interventions and by resources and systems (AIHW 2006). Many factors combine to affect the health of individuals and communities. People’s circumstances and the environment determine whether the population is healthy or not. Factors such as where people live, the state of their environment, genetics, their education level and income, and their relationships with friends and family, all are likely to impact on their health. The determinants of population health reflect the context of people’s lives; however, people are very unlikely to be able to control many of these determinants (WHO 2007). This chapter and Chapter 6 illustrate how various determinants can relate to, and influence other determinants, as well as health and wellbeing. We believe it is particularly important to provide an understanding of determinants and their relationship to health and illness in order to provide a structure in which a broader conceptualisation of health can be placed. Determinants of health do not exist in isolation from one another. More frequently they work together in a complex system. What is clear to anyone who works in public health is that many factors impact on the health and wellbeing of people. For example, in the next chapter we discuss factors such as living and working conditions, social support, ethnicity and class, income, housing, work stress and the impact of education on the length and quality of people’s lives. In 1974, the influential ‘Lalonde Report’ (Lalonde 1974) described key factors that impact on health status. These factors included lifestyle, environment, human biology and health services. Taking a population health approach builds on the Lalonde Report, and recognises that a range of factors, such as living and working conditions and the distribution of wealth in society, interact to determine the health status of a population. Tackling health determinants has great potential to reduce the burden of disease and promote the health of the general population. In summary, we understand very clearly now that health is determined by the complex interactions between individual characteristics, social and economic factors and physical environments; the entire range of factors that impact on health must be addressed if we are to make significant gains in population health, and focussing interventions on the health of the population or significant sub-populations can achieve important health gains. In 2007, the Australian Government included in the list of National Health Priority Areas the following health issues: cancer control, injury prevention and control, cardiovascular health, diabetes mellitus, mental health, asthma, and arthritis and musculoskeletal conditions. The National Health Priority Areas set the agenda for the Commonwealth, States and Territories, Local Governments and not-for-profit organisations to place attention on those areas considered to be the major foci for action. Many of these health issues are discussed in this chapter and the following chapter.

The impact of globalisation on health

After reading this chapter, you should be able to: • understand the concept of globalisation and appreciate its complexity • identify the significant impacts of globalisation on population health, particularly the incidence of communicable and non-communicable diseases • understand the distribution of the global burden of disease in high-, middle- and low-income countries • critically evaluate the factors contributing to the major causes of death in low-income countries • understand some of the achievements of the global public health community and appreciate the challenges it faces.

Vulnerability of axially loaded columns subjected to transverse impact loads

Increased industrialisation has brought to the forefront the susceptibility of concrete columns in both buildings and bridges to vehicle impacts. Accurate vulnerability assessments are crucial in the design process due to possible catastrophic nature of the failures that can cause. This paper reports on research undertaken to investigate the impact capacity of the columns of low to medium raised building designed according to Australian Standards. Numerical simulation techniques were used in the process and validation was done by using experimental results published in the literature. The investigation thus far has confirmed that vulnerability of typical columns in five story buildings located in urban areas to medium velocity car impacts and hence these columns need to be re-designed (if possible) or retrofitted. In addition, accuracy of the simplified method presented in EN 1991 to quantify the impact damage was scrutinised. A simplified concept to assess the damage due to all collisions modes was introduced. The research information will be extended to generate a common data base to assess the vulnerability of columns in urban areas against new generation of vehicles.

Numerical simulation of axially loaded concrete columns under transverse impact and vulnerability assessment

With a view to assessing the vulnerability of columns to low elevation vehicular impacts, a non-linear explicit numerical model has been developed and validated using existing experimental results. The numerical model accounts for the effects of strain rate and confinement of the reinforced concrete, which are fundamental to the successful prediction of the impact response. The sensitivity of the material model parameters used for the validation is also scrutinised and numerical tests are performed to examine their suitability to simulate the shear failure conditions. Conflicting views on the strain gradient effects are discussed and the validation process is extended to investigate the ability of the equations developed under concentric loading conditions to simulate flexural failure events. Experimental data on impact force–time histories, mid span and residual deflections and support reactions have been verified against corresponding numerical results. A universal technique which can be applied to determine the vulnerability of the impacted columns against collisions with new generation vehicles under the most common impact modes is proposed. Additionally, the observed failure characteristics of the impacted columns are explained using extended outcomes. Based on the overall results, an analytical method is suggested to quantify the vulnerability of the columns.

Validating the IS-Impact model in Australasian universities

This paper presents a novel study that aims to contribute to understanding the phenomenon of Enterprise Systems (ES) evaluation in Australasian universities. The proposed study addresses known limitations of arguably the most significant dependent variable in the Information System (IS) field - IS Success or IS-Impact. This study adopts the IS-Impact measurement model, reported by Gable et al. (2008), as the primary commencing theory-base and applies research extension strategy described by Berthon et al. (2002); extending both theory and the context. This study employs a longitudinal, multi-method research design, with two interrelated phases – exploratory and confirmatory. The exploratory phase aims to investigate the applicability and sufficiency of the IS-Impact dimensions and measures in the new context. The confirmatory phase will gather quantitative data to statistically validate IS-Impact model as a formative index.

Green cane impact on sugar processing : ISSCT process workshop 2008

The ISSCT Process Section workshop held in Réunion 20–23 October 2008 was attended by 51 delegates from 10 countries. The theme was Green cane impact on sugar processing. The workshop provided a valuable and timely opportunity to review and discuss the impact on factory operations and performance from a green cane supply that could include significant levels of trash. It was particularly relevant to those mills that were considering options to boost their biomass intake for increased co-generation capacity. Several of the speakers related their experiences with processing ‘whole of crop’ cane supplies through the factory. Speakers detailed the problems and increased losses that were incurred when processing cane with high trash levels. The consensus of the delegates was that the best scenario would involve a cane-cleaning plant at the factory so that only clean cane would be processed through the factory. The forum recommended that more research was required to address the issues of increased impurities in the process streams associated with high trash levels. Site visits to the two factories and a cane-delivery station were arranged as part of the workshop.

Dynamic energy absorption characteristics of foam-filled conical tubes under oblique impact loading

This paper treats the crush behaviour and energy absorption response of foam-filled conical tubes subjected to oblique impact loading. Dynamic computer simulation techniques validated by experimental testing are used to carry out a parametric study of such devices. The study aims at quantifying the energy absorption of empty and foam-filled conical tubes under oblique impact loading, for variations in the load angle and geometry parameters of the tube. It is evident that foam-filled conical tubes are preferable as impact energy absorbers due to their ability to withstand oblique impact loads as effectively as axial impact loads. Furthermore, it is found that the energy absorption capacity of filled tubes is better maintained compared to that of empty tubes as the load orientation increases. The primary outcome of this study is design information for the use of foam-filled conical tubes as energy absorbers where oblique impact loading is expected.

Analysis of primary user duty cycle impact on spectrum sensing performance

Spectrum sensing is considered to be one of the most important tasks in cognitive radio. Many sensing detectors have been proposed in the literature, with the common assumption that the primary user is either fully present or completely absent within the window of observation. In reality, there are scenarios where the primary user signal only occupies a fraction of the observed window. This paper aims to analyse the effect of the primary user duty cycle on spectrum sensing performance through the analysis of a few common detectors. Simulations show that the probability of detection degrades severely with reduced duty cycle regardless of the detection method. Furthermore we show that reducing the duty cycle has a greater degradation on performance than lowering the signal strength.

The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers

Aims To identify self-care activities undertaken and determine relationships between self-efficacy, depression, quality of life, social support and adherence to compression therapy in a sample of patients with chronic venous insufficiency. Background Up to 70% of venous leg ulcers recur after healing. Compression hosiery is a primary strategy to prevent recurrence, however, problems with adherence to this strategy are well documented and an improved understanding of how psychosocial factors influence patients with chronic venous insufficiency will help guide effective preventive strategies. Design Cross-sectional survey and retrospective medical record review. Method All patients previously diagnosed with a venous leg ulcer which healed between 12–36 months prior to the study were invited to participate. Data on health, psychosocial variables and self-care activities were obtained from a self-report survey and data on medical and previous ulcer history were obtained from medical records. Multiple linear regression modelling was used to determine the independent influences of psychosocial factors on adherence to compression therapy. Results In a sample of 122 participants, the most frequently identified self-care activities were application of topical skin treatments, wearing compression hosiery and covering legs to prevent trauma. Compression hosiery was worn for a median of 4 days/week (range 0–7). After adjustment for all variables and potential confounders in a multivariable regression model, wearing compression hosiery was found to be significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Conclusion In this sample, depression, self-efficacy and knowledge were found to be significantly related to adherence to compression therapy. Relevance to clinical practice These findings support the need to screen for and treat depression in this population. In addition, strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy.

Developing a hybrid expert system program to aid in the design of plastic injection molding process

Experts in injection molding often refer to previous solutions to find a mold design similar to the current mold and use previous successful molding process parameters with intuitive adjustment and modification as a start for the new molding application. This approach saves a substantial amount of time and cost in experimental based corrective actions which are required in order to reach optimum molding conditions. A Case-Based Reasoning (CBR) System can perform the same task by retrieving a similar case which is applied to the new case from the case library and uses the modification rules to adapt a solution to the new case. Therefore, a CBR System can simulate human e~pertise in injection molding process design. This research is aimed at developing an interactive Hybrid Expert System to reduce expert dependency needed on the production floor. The Hybrid Expert System (HES) is comprised of CBR, flow analysis, post-processor and trouble shooting systems. The HES can provide the first set of operating parameters in order to achieve moldability condition and producing moldings free of stress cracks and warpage. In this work C++ programming language is used to implement the expert system. The Case-Based Reasoning sub-system is constructed to derive the optimum magnitude of process parameters in the cavity. Toward this end the Flow Analysis sub-system is employed to calculate the pressure drop and temperature difference in the feed system to determine the required magnitude of parameters at the nozzle. The Post-Processor is implemented to convert the molding parameters to machine setting parameters. The parameters designed by HES are implemented using the injection molding machine. In the presence of any molding defect, a trouble shooting subsystem can determine which combination of process parameters must be changed iii during the process to deal with possible variations. Constraints in relation to the application of this HES are as follows. - flow length (L) constraint: 40 mm < L < I 00 mm, - flow thickness (Th) constraint: -flow type: - material types: I mm < Th < 4 mm, unidirectional flow, High Impact Polystyrene (HIPS) and Acrylic. In order to test the HES, experiments were conducted and satisfactory results were obtained.