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.

Terminally-ill people living alone without a caregiver: an Australian national scoping study of palliative care needs

Home-based palliative care services are facing increasing challenges in servicing the needs of clients who live alone and without a primary caregiver. The findings from the analysis of 721 services’ records from three Australian states, and feedback from health professionals in interviews and postal surveys, demonstrated that there were aspects of being on one’s own with a terminal illness and living at home that require a specialised approach and support. This study explored the issues of palliative care patients living alone, from a service provider perspective, and provided evidence-based information to assist with service planning. The study made recommendations to the Australian Department of Health and Ageing about services considered important in developing support structures for this growing population.

Community knowledge and beliefs about ADHD

Accurate knowledge and positive attitudes within the community are important for the effective diagnosis, treatment and support of people with ADHD. Most previous research about knowledge and attitudes has focused only on professional groups and parents of children with ADHD. The aim of this study was to explore knowledge about ADHD characteristics and causes, and attitudes towards issues such as medication in the general population. Six hundred and forty-five members of the Australian community, all of whom were parents, completed a questionnaire. The findings showed that the core features of ADHD were well-known, but there were misconceptions and considerable uncertainty about many aspects. Most respondents failed to recognise the genetic basis of the disorder and its potentially lifelong nature. Fathers were less knowledgeable than mothers. Although most participants believed that ADHD is a genuine disorder and recognised the benefits of medication, the majority believed that it is diagnosed too frequently and that medication is prescribed too readily. The study concluded that, in many respects, the public is not well-informed about ADHD and suggested that the media may have an important role in enhancing community awareness of the disorder through responsible, sensitive and accurate reporting.

Modelling and control of a quad-rotor robot

To date, most quad-rotor aerial robots have been based on flying toys. Although such systems can be used as prototypes, they are not sufficiently robust to serve as experimental robotics platforms. We have developed the X-4 Flyer, a quad-rotor robot using custom-built chassis and avionics with off-the-shelf motors and batteries, to be a highly reliable experimental platform. The vehicle uses tuned plant dynamics with an onboard embedded attitude controller to stabilise flight. A linear SISO controller was designed to regulate flyer attitude.

Implicit discount rates and fisheries management : is there a relationship?

Fishers are faced with multiple risks, including unpredictability of future catch rates, prices and costs. While the latter are largely beyond the control of fisheries managers, effective fisheries management should reduce uncertainty about future catches. Different management instruments are likely to have different impacts on the risk perception of fishers, and this should manifest itself in their implicit discount rate. Assuming licence and quota values represent the net present value of the flow of expected future profits, then a proxy for the implicit discount rate of vessels in a fishery can be derived by the ratio of the average level of profits to the average licence/quota value. From this, an indication of the risk perception can be derived, assuming higher discount rates reflect higher levels of systematic risk. In this paper, we apply the capital asset pricing model (CAPM) to determine the risk premium implicit in the discount rates for a range of Australian fisheries, and compare this with the set of management instruments in place. We test the assumption that rights based management instruments lower perceptions of risk in fisheries. We find little evidence to support this assumption. although the analysis was based on only limited data.

Cross-cultural comparison of anxiety symptoms in Colombian and Australian children

Introduction: This cross-cultural study compared both the symptoms of anxiety and their severity in a community sample of children from Colombia and Australia. Method: The sample comprised 516 children (253 Australian children and 263 Colombian children), aged 8 to 12-years-old. The Spence Children’s Anxiety Scale (SCAS) was used to measure both the symptoms and levels of anxiety. Results: The results showed a significant difference in the severity of the symptoms between the children in the two countries. In general, Colombian children reported more severe symptoms than their Australian peers, however there were no difference in the types of symptoms reported by the children in the two countries. Discussion and Conclusion: The implications of these findings and their importance to cross-cultural research are discussed.

Safety impacts of alcohol and other drugs in the construction industry : a research methodology

Anecdotal evidence from the infrastructure and building sectors highlights issues of drugs and alcohol and its association with safety risk on construction sites. Operating machinery and mobile equipment, proximity to live traffic together with congested sites, electrical equipment and operating at heights conspire to accentuate the potential adverse impact of drugs and alcohol in the workplace. While most Australian jurisdictions have identified this as a critical safety issue, information is limited regarding the prevalence of alcohol and other drugs in the workplace and there is limited evidential guidance regarding how to effectively and efficiently address such an issue. No known study has scientifically evaluated the relationship between the use of drugs and alcohol and safety impacts in construction, and there has been only limited adoption of nationally coordinated strategies, supported by employers and employees to render it socially unacceptable to arrive at a construction workplace with impaired judgement from drugs and alcohol. A nationally consistent collaborative approach across the construction workforce - involving employers and employees; clients; unions; contractors and sub-contractors is required to engender a cultural change in the construction workforce – in a similar manner to the on-going initiative in securing a cultural change to drink-driving in our society where peer intervention and support is encouraged. This study has four key objectives. Firstly, using the standard World Health Organisation AUDIT, a national qualitative and quantitative assessment of the use of drugs and alcohol will be carried out. This will build upon similar studies carried out in the Australian energy and mining sectors. Secondly, the development of an appropriate industry policy will adopt a non-punitive and rehabilitative approach developed in consultation with employers and employees across the infrastructure and building sectors, with the aim it be adopted nationally for adoption at the construction workplace. Thirdly, an industry-specific cultural change management program will be developed through a nationally collaborative approach to reducing the risk of impaired performance on construction sites and increasing workers’ commitment to drugs and alcohol safety. Finally, an implementation plan will be developed from data gathered from both managers and construction employees. Such an approach stands to benefit not only occupational health and safety, through a greater understanding of the safety impacts of alcohol and other drugs at work, but also alcohol and drug use as a wider community health issue. This paper will provide an overview of the background and significance of the study as well as outlining the proposed methodology that will be used to evaluate the safety impacts of alcohol and other drugs in the construction industry.

Evaluation of fruit and vegetable intakes of Australian adults: the nutrition survey 1995

Objective: To evaluate the fruit and vegetable intakes of Australian adults aged 19-64 years. Methods: Intake data were collected as part of the National Nutrition Survey 1995 representing all Australian States and Territories, including city, metropolitan, rural and remote areas. Dietary intake of 8,891 19-to-64 year-olds was assessed using a structured 24-hour recall. Intake frequency was assessed as the proportion of participants consuming fruit and vegetables on the day prior to interview and variety was assessed as the number of subgroups of fruit and vegetables consumed. Intake levels were compared with the recommendations of the Australian Guide to Healthy Eating (AGHE). Results: Sixty-two per cent of participants consumed some fruit and 89% consumed some vegetables on the day surveyed. Males were less likely to consume fruit and younger adults less likely to consume fruit and vegetables compared with females and older adults respectively. Variety was primarily low (1 subcategory) for fruit and medium (3-4 subcategories) for vegetables. Thirty-two per cent of adults consumed the minimum two serves of fruit and 30% consumed the minimum five serves of vegetables as recommended by the AGHE. Eleven per cent of adults met the minimum recommendations for both fruit and vegetables. Conclusion: A large proportion of adults have fruit and vegetable intakes below the AGHE minimum recommendations. Implications: A nationally integrated, longterm campaign to increase fruit and vegetable consumption, supported by policy changes to address structural barriers to consumption, is vital to improve fruit and vegetable consumption among adults

Collaborative research to develop a specialist, post-graduate competency-based education curriculum and continuing professional development structure for health librarians in Australia

Through a grant received from the Australian Library and Information Association (ALIA), members of Health Libraries Australia (HLA) are collaborating with a researcher/educator to conduct a twelve month research project with the goal of developing an educational framework for the Australian health librarianship workforce of the future. The collaboration comprises the principal researcher and a representative group of practitioners from different sectors of the health industry who are affiliated with ALIA in various committees, advisory groups and roles. The research has two main aims: to determine the future skills requirements for the health librarian workforce in Australia; and to develop a structured, modular education framework for specialist post-graduate qualifications together with a structure for ongoing continuing professional development. The paper highlights some of the major trends in the health sector and some of the main environmental influences that may act as drivers for change for health librarianship as a profession, and particularly for educating the future workforce. The research methodology is outlined and the main results are described; the findings are discussed with regard to their implications for the development of a structured, competency-based education framework.

The contemporary librarian : skills, knowledge and attributes required in a world of emerging technologies

Seventy-six librarians participated in a series of focus groups in support of research exploring the skills, knowledge and attributes required by the contemporary library and information professional in a world of every changing technology. The project was funded by the Australian Learning and Teaching Council. Text data mining analysis revealed three main thematic clusters (libraries, people, jobs) and one minor thematic cluster (community). Library 2.0 was broadly viewed by participants as being about change whilst librarian 2.0 was perceived by participants as not a new creation but just about good librarian practices. Participants expressed the general belief that personality traits, not just qualifications, were critical to be a successful librarian or information worker in the future.

Identifying child sexual abuse within school contexts : policy problems and solutions, and a landmark case

As a strategy to identify child sexual abuse, most Australian States and Territories have enacted legislation requiring teachers to report suspected cases. Some Australian State and non-State educational authorities have also created policy-based obligations to report suspected child sexual abuse. Significantly, these can be wider than non-existent or limited legislative duties, and therefore are a crucial element of the effort to identify sexual abuse. Yet, no research has explored the existence and nature of these policy-based duties. The first purpose of this paper is to report the results of a three-State study into policy-based reporting duties in State and non-State schools in Australia. In an extraordinary coincidence, while conducting the study, a case of failure to comply with reporting policy occurred with tragic consequences. This led to a rare example in Australia (and one of only a few worldwide) of a professional being prosecuted for failure to comply with a legislative duty. It also led to disciplinary proceedings against school staff. The second purpose of this paper is to describe this case and connect it with findings from our policy analysis.

The relationship between Australians and the overseas graves of the First World War

The purpose of this thesis is to outline the relationship that existed in the past and exists in the present, between Australians and the War Graves and Memorials to the Missing. commemorations of Australians who died during the First World War. Their final resting places are scattered all over the world and provide a tangible record of the sacrifice of men and women in the war, and represent the final result by Official Agencies such as the Imperial, and later, Commonwealth War Graves Commission, and its agency representative, the Office of Australian War Graves, of an attempt to appropriately commemorate them. The study follows the path of history from the event of death of an individual in the First World War, through their burial; temporary grave or memorial commemoration; the permanent commemoration; the family and public reaction to the deaths; how the Official Agencies of related Commonwealth Governments dealt with the dead; and finally, how the Australian dead are represented on the battlefields of the world in the 21st century. Australia.s war dead of the First World War are scattered around the globe in more than 40 countries and are represented in war cemeteries and civil cemeteries; and listed on large „Memorials to the Missing., which commemorate the individuals devoid of a known graves or final resting place.

Australian construction industry KPIs

The Australian Construction Industry Forum (which is a peak industry association) and the Australian Procurement and Construction Council (which is a peak government organisation) have jointly agreed on a set of KPIs for the Australian Construction Industry. The goal of such a process is to work collaboratively in order to lift industry performance overall, and thereby bring about economic and social benefits to the industry and broader community. This paper seeks to underpin the process of KPI measurement by providing: an overview of international approaches to KPI measurement, summary of difficulties identified in performance measurement together with possible responses to these problems, and finally a discussion on the various methods for reporting KPIs. A number of findings throughout the paper, based on the review, made in order to advance the goal of performance measurement in the construction industry in Australia. Such findings would be relevant to other countries considering a KPI measurement process as well.

A green drought : the challenge of mentoring for Australian accounting academics

Purpose: The purpose of this paper is to expose the impact of the shortage of senior academics,particularly professors, in Australian accounting schools, to relate the way one school addressed this shortage through a mentoring scheme, and to challenge existing institutional arrangements.----------- Design/methodology/approach: This is a contextualised qualitative case study of a mentoring scheme conducted in an Australian accounting school. Data collected from semi-structured interviews, personal reflections and from Australian university web sites are interpreted theoretically using the metaphor of a “green drought”.---------- Findings: The mentoring scheme achieved some notable successes, but raised many issues and challenges. Mentoring is a multifaceted investment in vocational endeavour and intellectual infrastructure, which will not occur unless creative means are developed over the long term to overcome current and future shortages of academic mentors.---------- Research limitations/implications: This is a qualitative case study, which, therefore, limits its generalisability. However, its contextualisation enables insights to be applied to the wider academic environment. ----------Practical implications: In the Australian and global academic environment, as accounting professors retire in greater numbers, new and creative ways of mentoring will need to be devised. The challenge will be to address longer term issues of academic sustainability, and not just to focus on short-term academic outcomes.---------- Originality/value: A mentoring scheme based on a collegial networking model of mentoring is presented as a means of enhancing academic endeavour through a creative short-term solution to a shortage of accounting professors. The paper exemplifies the theorising power of metaphor in a qualitative study.

Early relational reasoning and the novice programmer : swapping as the “hello world” of relational reasoning

We report on a longitudinal research study of the development of novice programmers in their first semester of programming. In the third week, almost half of our sample of students could not answer an explain-in-plain-English question, for code consisting of just three assignment statements, which swapped the values in two variables. We regard code that swaps the values of two variables as the simplest case of where a programming student can manifest a SOLO relational response. Our results demonstrate that the problems many students face with understanding code can begin very early, on relatively trivial code. However, using traditional programming exercises, these problems often go undetected until late in the semester. New approaches are required to detect and fix these problems earlier.