The Global Protection of Personal Health Data

The workshop is an activity of the IMIA Working Group ‘Security in Health Information Systems’ (SiHIS). It is focused to the growing global problem: how to protect personal health data in today’s global eHealth and digital health environment. It will review available trust building mechanisms, security measures and privacy policies. Technology alone does not solve this complex problem and current protection policies and legislation are considered woefully inadequate. Among other trust building tools, certification and accreditation mechanisms are dis-cussed in detail and the workshop will determine their acceptance and quality. The need for further research and international collective action are discussed. This workshop provides an opportunity to address a critical growing problem and make pragmatic proposals for sustainable and effective solutions for global eHealth and digital health.

Submission for the Queensland Government Parliamentary Inquiry into personal health promotion interventions using telephone and web-based technologies

Telephone and web-based technologies such as SMS, smartphone apps, gamification, online/mobile games, online quizzes and tools can be used in personal health interventions in two ways: health promotion or social marketing. In response to the Queensland government's call for submissions to the parliamentary inquiry, a social marketing and design submission from four of the faculties at Queensland University of Technology was submitted. There appears to be a great deal of confusion in government circles about the terms ‘social marketing’ and ‘health promotion’ and often they are used interchangeably when they are actually significantly different approaches. Social marketing is the science and practice of behaviour change and involves goods and services that offer a value proposition, and which incentivises citizens to change their behaviour voluntarily. However, social marketing is often mistakenly used to describe advertising and communication or social media marketing. This submission contains an overview of how technology interventions need to be implemented to be successful, provides examples of the evidence that telephone and web-based interventions can effectively influence public health outcome. This submission poses seven critical factors.

Putting the 'Personal' back into injury: An interpretation of Pt 3-5 of the ACL

There is an ongoing debate in relation to Part 3-5 of the ACL, particularly over its use in relation to other civil liability remedies. This article looks more closely at ss 138 and 139. It argues that, because of a possible design flaw in the statutory construction of s 138, it can be interpreted much more broadly than it has been to date. Also, the paper discusses the effect on an interpretation of s 139 ACL of both the High Court’s decision in Marks v GIO Australia Holdings Ltd, and a small but significant amendment to s 139 when the ACL was enacted. It argues that s 139 can now be interpreted broadly to include claims not just for loss of financial support or services but for all loss or damage or injury caused.

Exposure to bioaerosols in the school environment in Brisbane, Australia

Introduction: Exposure to bioaerosols in indoor environments has been linked to various adverse health effects, such as airway disorders and upper respiratory tract symptoms. The aim of this study was to assess exposure to bioaerosols in the school environment in Brisbane, Australia. Methods: Culturable fungi and endotoxin measurements were conducted in six schools between October 2010 and May 2011. Culturable fungi (2 indoor air and 1-2 outdoor air samples per school) were assessed using a Biotest RCS High Flow Air Sampler, with a flow rate of either 50L/min or 20L/min. A rose pengar agar was used for recovery, which was incubated prior to counting and partial identification. Endotoxins were sampled (8h, 2L/min) using SKC glass fibre filters (4 indoor air samples per school) and analysed using an endpoint chromogenic LAL assay. Results: The arithmetic mean for fungi concentration in indoor and outdoor air was 710 cfu/m3(125- 1900 cfu/m3) and 524 cfu/m3 (140-1250 cfu/m3), respectively. The most frequently isolated fungal genus from the outdoor air was Cladosporium (over 40 %), followed by isolated Penicillium (21%) and Aspergillus (12%). The percent of Penicillium, Cladosporium and Aspergillus in indoor air samples was 32%, 32% and 8%, respectively. The aritmetic mean of endotoxin concentration was 0.59 EU/m3 (0-2,2 EU/m3). Discussion: The results of the current study are in agreement with previously reported studies, in that airborne fungi and endotoxin concentrations varied extensively, and were mostly dependent on climatic conditions. In addition, the indoor air mycoflora largely reflected the fungal flora present in the outdoor air, with Cladosporium being the most common in both outdoor and indoor (with Penicillium) air. In indoor air, unusually high endotoxin levels, over 1 EU/m3, were detected at 2 schools. Although these schools were not affected by the recent Brisbane floods, persistent rain prior to and during the study perios could explain the results.

Ultrafine particle emission of waste incinerators and comparison to the exposure of urban citizens

On the basis of the growing interest on the impact of airborne particles on human exposure as well as the strong debate in Western countries on the emissions of waste incinerators, this work reviewed existing literature to: (i) show the emission factors of ultrafine particles (particles with a diameter less than 100 nm) of waste incinerators, and; (ii) assess the contribution of waste incinerators in terms of ultrafine particles to exposure and dose of people living in the surrounding areas of the plants in order to estimate eventual risks. The review identified only a limited number of studies measuring ultrafine particle emissions, and in general they report low particle number concentrations at the stack (the median value was equal to 5.5×103 part cm-3), in most cases higher than the outdoor background value. The lowest emissions were achieved by utilization of the bag-house filter which has an overall number-based filtration efficiency higher than 99%. Referring to reference case, the corresponding emission factor is equal to 9.1×1012 part min-1, that is lower than one single high-duty vehicle. Since the higher particle number concentrations found in the most contributing microenvironments to the exposure (indoor home, transportation, urban outdoor), the contribution of the waste incinerators to the daily dose can be considered as negligible.

Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study

Background Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China. Methods We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25–29.9 and ≥ 30 kg/m2, respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006–2008) average concentrations of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates. Results We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15–1.47 for stroke, 1.33–1.59 for CVDs), less strong in overweight subjects (OR 1.22–1.35 for stroke, 1.07–1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98–1.01 for stroke, 0.93–1.15 for CVDs). When stratified by gender, these interactions were significant only in women. Conclusions Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality of BMI relative to exposure and onset of disease.

Dynamics of reverse salience as technological performance gap: An empirical study of the personal computer technology system

The evolution of technological systems is hindered by systemic components, referred to as reverse salients, which fail to deliver the necessary level of technological performance thereby inhibiting the performance delivery of the system as a whole. This paper develops a performance gap measure of reverse salience and applies this measurement in the study of the PC (personal computer) technological system, focusing on the evolutions of firstly the CPU (central processing unit) and PC game sub-systems, and secondly the GPU (graphics processing unit) and PC game sub-systems. The measurement of the temporal behavior of reverse salience indicates that the PC game sub-system is the reverse salient, continuously trailing behind the technological performance of the CPU and GPU sub-systems from 1996 through 2006. The technological performance of the PC game sub-system as a reverse salient trails that of the CPU sub-system by up to 2300 MHz with a gradually decreasing performance disparity in recent years. In contrast, the dynamics of the PC game sub-system as a reverse salient trails the GPU sub-system with an ever increasing performance gap throughout the timeframe of analysis. In addition, we further discuss the research and managerial implications of our findings.

Job uncertainty and personal control during downsizing: A comparison of survivors and victims

This study developed and tested a model of job uncertainty for survivors and victims of downsizing. Data were collected from three samples of employees in a public hospital, each representing three phases of the downsizing process: immediately before the announcement of the redeployment of staff, during the implementation of the downsizing, and towards the end of the official change programme. As predicted, levels of job uncertainty and personal control had a direct relationship with emotional exhaustion and job satisfaction. In addition, there was evidence to suggest that personal control mediated the relationship between job uncertainty and employee adjustment, a pattern of results that varied across each of the three phases of the change event. From the perspective of the organization’s overall climate, it was found that levels of job uncertainty, personal control and job satisfaction improved and/or stabilized over the downsizing process. During the implementation phase, survivors experienced higher levels of personal control than victims, but both groups of employees reported similar levels of job uncertainty. We discuss the implications of our results for strategically managing uncertainty during and after organizational change.

Wrestling with schools, schooling and educational research (Personal Reflections on the European Union-supported Educational Research 1995-2003: Briefing Papers for Policy Makers)

I must admit that I approached the European Union-supported educational research 1995-2003: Briefing papers for policy makers with a sense of trepidation. As a researcher who defines himself as socially critical, I wondered about the dynamics of a policy document that was published by the bureaucracy that has, in some form, a vested interest in the structure and operation of education in its various guises. In turning my attention to this review, I decided to focus my attention on the third guiding question that argues education and training "are strongly interconnected with concerns that include citizenship and democratic participation, inequalities and social justice, cultural diversity and quality of life" (Millei, 2005). The Briefing Papers include recommendations on democracy and citizenship, social exclusion and equality, gender and dealing with mental illness in schools...

Pedestrian Crashes in Ethiopia: Identification of contributing factors through modelling of exposure and road environment variables

Pedestrian safety is a critical issue in Ethiopia. Reports show that 50 to 60% of traffic fatality victims in the country are pedestrians. The primary aim of this research was to examine the possible causes of and contributing factors to crashes with pedestrians in Ethiopia, and improve pedestrian safety by recommending possible countermeasures. The secondary aim was to develop appropriate pedestrian crash models for two-way two-lane rural roads and roundabouts in the capital city of Ethiopia. This research uses quantitative methods throughout the process of the investigation. The research has applied various statistical methods. The results of this research support the idea that geometric and operational features have significant influence on pedestrian safety and crashes. Accordingly, policies and strategies are needed to safeguard pedestrians in Ethiopia.

Mentors’ personal attributes for enhancing their mentees’ primary science teaching

Problems can occur in mentoring relationships if there is a “lack of mentoring skills on the part of the mentor” (Soutter, Kerr - Roubicek & Smith, 2000, p. 6), which includes the effectiveness of mentor’s personal attributes. There is little Australian research that analyses primary teachers’ personal attributes for mentoring; hence this study aims to examine preservice teachers’ perceptions of their mentors’ personal attributes. Specifically, this study focuses on mentors’ personal attributes in relation to their mentoring of primary science teaching....

Biomonitoring of polycyclic aromatic hydrocarbons exposure in small groups of residents in Brisbane, Australia and Hanoi, Vietnam, and those travelling between the two cities

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with adverse health outcomes. Concentrations of urinary PAH metabolites (OH-PAHs) provide an integrated measure of human exposure to PAHs but measurement of urinary OH-PAHs has not been done in Australia and rarely in Vietnam, where air pollution is of concern. In this study, we assessed exposure to PAHs in 16 participants living in Brisbane, Australia and Hanoi, Vietnam, with 4 participants travelling between the two cities during the monitoring period. A total of 312 first morning urine samples were collected over 10 weeks and were analysed for nine OH-PAHs. Concentrations of the urinary OH-PAHs were 2–10 times higher in participants from Hanoi than those from Brisbane. For example, the median concentrations of 1-hydroxypyrene were 292 pg/mL in Hanoi, compared to 64 pg/mL in Brisbane. For participants travelling from Brisbane to Hanoi and back, differences in exposure to PAHs in these two cities resulted in corresponding changes of urinary OH-PAH concentrations, demonstrating that the more polluted environment in Hanoi was likely the source for higher PAH exposure there.

Authentically ambiguous, credibly anonymous: Perceptually reframing the personal narrative towards effective persuasion in aggressive human rights contexts

Testing the strategies of discourse and materiality, this practice-based and practice-led research experiments with how anonymous storytelling by vulnerable communities, like that of the sexual minorities and their allies in Malaysia, can better speak to their human rights issues without further subjecting them to personal attacks and targetted persecution. The research identifies the critical role of the voice in lending authenticity and credibility to first person narratives; and contextual credibility as a form of credibility which personal stories naturally aspire to achieve with audiences. Adopting a discursive view of persuasion and recognising too that the power of persuasion may in effect lie with those who receive these stories rather than with those who tell them, the insights and knowledge gained from the research informed the development of the field output, Persuasive Storytelling by Vulnerable Communities in Aggressive Contexts: A Human Rights Communication Framework.

Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults

Background Recovery strategies are often usedwith the intention of preventing orminimisingmuscle soreness after exercise. Whole-body cryotherapy, which involves a single or repeated exposure(s) to extremely cold dry air (below -100 °C) in a specialised chamber or cabin for two to four minutes per exposure, is currently being advocated as an effective intervention to reduce muscle soreness after exercise. Objectives To assess the effects (benefits and harms) of whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, the British Nursing Index and the Physiotherapy Evidence Database. We also searched the reference lists of articles, trial registers and conference proceedings, handsearched journals and contacted experts. The searches were run in August 2015. Selection criteria We aimed to include randomised and quasi-randomised trials that compared the use of whole-body cryotherapy (WBC) versus a passive or control intervention (rest, no treatment or placebo treatment) or active interventions including cold or contrast water immersion, active recovery and infrared therapy for preventing or treating muscle soreness after exercise in adults. We also aimed to include randomised trials that compared different durations or dosages of WBC. Our prespecified primary outcomes were muscle soreness, subjective recovery (e.g. tiredness, well-being) and adverse effects. Data collection and analysis Two review authors independently screened search results, selected studies, assessed risk of bias and extracted and cross-checked data. Where appropriate, we pooled results of comparable trials. The random-effects model was used for pooling where there was substantial heterogeneity.We assessed the quality of the evidence using GRADE. Main results Four laboratory-based randomised controlled trials were included. These reported results for 64 physically active predominantly young adults (mean age 23 years). All but four participants were male. Two trials were parallel group trials (44 participants) and two were cross-over trials (20 participants). The trials were heterogeneous, including the type, temperature, duration and frequency of WBC, and the type of preceding exercise. None of the trials reported active surveillance of predefined adverse events. All four trials had design features that carried a high risk of bias, potentially limiting the reliability of their findings. The evidence for all outcomes was classified as ’very low’ quality based on the GRADE criteria. Two comparisons were tested: WBC versus control (rest or no WBC), tested in four studies; and WBC versus far-infrared therapy, also tested in one study. No studies compared WBC with other active interventions, such as cold water immersion, or different types and applications of WBC. All four trials compared WBC with rest or no WBC. There was very low quality evidence for lower self-reported muscle soreness (pain at rest) scores after WBC at 1 hour (standardised mean difference (SMD) -0.77, 95% confidence interval (CI) -1.42 to -0.12; 20 participants, 2 cross-over trials); 24 hours (SMD -0.57, 95%CI -1.48 to 0.33) and 48 hours (SMD -0.58, 95% CI -1.37 to 0.21), both with 38 participants, 2 cross-over studies, 1 parallel group study; and 72 hours (SMD -0.65, 95% CI -2.54 to 1.24; 29 participants, 1 cross-over study, 1 parallel group study). Of note is that the 95% CIs also included either no between-group differences or a benefit in favour of the control group. One small cross-over trial (9 participants) found no difference in tiredness but better well-being after WBC at 24 hours post exercise. There was no report of adverse events. One small cross-over trial involving nine well-trained runners provided very low quality evidence of lower levels of muscle soreness after WBC, when compared with infrared therapy, at 1 hour follow-up, but not at 24 or 48 hours. The same trial found no difference in well-being but less tiredness after WBC at 24 hours post exercise. There was no report of adverse events. Authors’ conclusions There is insufficient evidence to determine whether whole-body cryotherapy (WBC) reduces self-reportedmuscle soreness, or improves subjective recovery, after exercise compared with passive rest or no WBC in physically active young adult males. There is no evidence on the use of this intervention in females or elite athletes. The lack of evidence on adverse events is important given that the exposure to extreme temperature presents a potential hazard. Further high-quality, well-reported research in this area is required and must provide detailed reporting of adverse events.

Differences in grass pollen allergen exposure across Australia

Objective Allergic rhinitis and allergic asthma are important chronic diseases posing serious public health issues in Australia with associated medical, economic, and societal burdens. Pollen are significant sources of clinically relevant outdoor aeroallergens, recognised as both a major trigger for, and cause of, allergic respiratory diseases. This study aimed to provide a national, and indeed international, perspective on the state of Australian pollen data using a large representative sample. Methods Atmospheric grass pollen concentration is examined over a number of years within the period 1995 to 2013 for Brisbane, Canberra, Darwin, Hobart, Melbourne, and Sydney, including determination of the clinical' grass pollen season and grass pollen peak. Results The results of this study describe, for the first time, a striking spatial and temporal variability in grass pollen seasons in Australia, with important implications for clinicians and public health professionals, and the Australian grass pollen-allergic community. Conclusions These results demonstrate that static pollen calendars are of limited utility and in some cases misleading. This study also highlights significant deficiencies and limitations in the existing Australian pollen monitoring and data. Implications: Establishment of an Australian national pollen monitoring network would help facilitate advances in the clinical and public health management of the millions of Australians with asthma and allergic rhinitis.