Now the real international fight begins for the Trans-Pacific Partnership

In Atlanta, the trade ministers of a dozen countries across the Pacific Rim announced that they had successfully reached a concluded agreement upon the Trans-Pacific Partnership. The debate over the TPP will now play out in legislatures across the Pacific Rim, where sentiment towards the deal is much more mixed. The ministers insisted: “After more than five years of intensive negotiations, we have come to an agreement that will support jobs, drive sustainable growth, foster inclusive development, and promote innovation across the Asia-Pacific region … The agreement achieves the goal we set forth of an ambitious, comprehensive, high standard and balanced agreement that will benefit our nation’s citizens … We expect this historic agreement to promote economic growth, support higher-paying jobs; enhance innovation, productivity and competitiveness; raise living standards; reduce poverty in our countries; and to promote transparency, good governance, and strong labor and environmental protections.” But there has been fierce criticism of the Trans-Pacific Partnership, because of both its secrecy and its substance. Nobel Laureate Professor Joseph Stiglitz has warned that the agreement is not about free trade, but about the protection of corporate monopolies. The intellectual property chapter provides for longer and stronger protection of intellectual property rights. The investment chapter provides foreign investors with the power to challenge governments under an investor-state dispute settlement (ISDS) regime. The environment chapter is weak and toothless, and seems to be little more than an exercise in greenwashing. The health annex — and many other parts of the agreement — strengthen the power of pharmaceutical companies and biotechnology developers. The text on state-owned enterprises raises concerns about public ownership of postal services, broadcasters and national broadband services.

Editorial of "International Journal of Critical Indigenous Studies, Volume 7, Number 1, 2014"

This edition testifies to the broad international reach of the journal, with contributions variously concerned with Arctic Indigenous communities, the Métis of Canada, Native Hawaiians and Māori of Aotearoa (New Zealand). Two articles stress the need to work collaboratively and respectfully with Indigenous populations whilst conducting research. The first, by Gwen Healey, notes the increased interest in health research in the Arctic, particularly with Inuit populations. Healy seeks to add to the growing body of literature concerned with Indigenous ways of knowing by highlighting Inuit concepts that inform an effective Arctic research model. The second, by primary author Peter Hutchinson and a range of co-contributors, highlights the ways in which Métis collaborators working in health developed a participatory Indigenous research method that was unique in that it foregrounded Métis relationships and relationality. In so doing, the researchers were able to give substance to otherwise staid policy statements about the need for good ethical research conduct.

Editorial of "International Journal of Critical Indigenous Studies, Volume 7, Number 2, 2014"

This edition scales the merlons and embrasures that mark the epistemological barriers that contemporary colonising power continually puts in place. Each article harnesses a critical Indigenous perspective in order to challenge conservative approaches or positions, be they concerned with reconciliation, Indigenous-led research, research tools or the nature of Aboriginal being. The first article, by Barry Judd and Emma Barrow, examines reconciliation discourse within the higher education sector and highlights the ways a normative Anglo-Australian identity militates against genuine ‘whitefella’ attempts to ‘reconcile’. The authors stress the importance of inclusive, institutional practice that serves to decentre Anglo-centrism and which, in turn, brings Indigenous peoples more fully into the fold of Australian university life.

Editorial of "International Journal of Critical Indigenous Studies, Volume 8, Number 1, 2015"

This edition includes a diverse range of contributions that collectively illustrate two elevated concerns of critical Indigenous studies: First, an interest in establishing ways and means of conducting ethical research with Indigenous communities; and second, critically engaging with constructions of Indigeneity. The first article, by Craig Sinclair, Peter Keelan, Samuel Stokes, Annette Stokes and Christine Jefferies-Stokes, examines the increasingly popular use of participatory video (PV) as a means of engagement, in this case with children in remote Aboriginal communities as participants in health research. The authors note that, whilst not without methodological disadvantages, the PV method, with its flexibility to respond to community priorities is particularly well suited to research with remote Aboriginal communities.

Salutogenic design: The neurological basis of health-promoting environments

All architecture embodies narratives that may either support or work against a state of good health. Neurological theory can be used to explain why salutogenic environments work, and how they can improve health outcomes.

Psychiatric design : Using a salutogenic model for the development and management of mental health facilities

The prevailing model of psychiatric facility design does not fulfil its potential in supporting the healing process. A salutogenic approach can improve coherence and foster meaning, will actually improve mental health outcomes, not only manage patient behaviour.

Editorial of "International Journal of Critical Indigenous Studies Volume 4, Number 2, 2011"

This special edition of the International Journal of Critical Indigenous Studies focuses upon the work scholars within the growing discipline of Aboriginal and Torres Strait Islander health studies. The lamentable state of Indigenous health in Australia is reflected in Indigenous populations elsewhere, especially where settler colonialism has left an indelible mark. This special edition therefore speaks to where Indigenous health outcomes and the efficacy of remedies are causing concern. Common to all is the demand that Indigenous people are placed front and centre of all attempts to improve health outcomes and that improvements are sought in culturally sensitive ways. Terry Dunbar presents findings from a research study that set out to investigate the Indigenous experiences of health and family services in the Northern Territory, Australia. The study asserts that cultural security is an integral and vital element of any policy that will impact upon Indigenous peoples. Dunbar concludes by arguing that in seeking positive change with regard to cultural security or otherwise, the most vociferous champions of that change are likely to be the Aboriginal communities affected. The article by Bronwyn Fredericks, Karen Adams, Sandra Angus and Melissa Walker also highlights the need to involve Aboriginal and Torres Strait Islander people, in this case women, in the design and development of strategies affecting their lives. Utilising routine communication methods such the ‘talking circle’ and the process referred to as ‘talkin’ up’, where women ‘talk back’ to one another about issues of personal importance, the article argues that the health strategy which emerged through these consultation approaches was more accurately informed by and responsive to women’s health need. Indeed, the resulting strategy reflected the women’s sense of themselves and the clear direction they felt their health services and polices should take.

Symposium: Food pricing and affordability of ‘healthy’ versus ‘less healthy’ diets: An international approach to monitoring and surveillance

Symposium co-ordinated by The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) Purpose Global monitoring of the price and affordability of foods, meals and diets is urgently needed. There are major methodological challenges in developing robust, cost-effective, standardized, and policy relevant tools, pertinent to nutrition, obesity, and diet-related non-communicable diseases and their inequalities. There is increasing pressure to take into account environmental sustainability. Changes in price differentials and affordability need to be comparable between and within countries and over time. Robust tools could provide baseline data for monitoring and evaluating structural, economic and social policies at the country/regional and household levels. INFORMAS offers one framework for consideration.

Measuring the impact of burn scarring on health-related quality of life: Development and preliminary content validation of the Brisbane Burn Scar Impact Profile (BBSIP) for children and adults

INTRODUCTION No burn-scar specific, health-related quality of life (HRQOL) measure exists. This study aimed to develop a patient-reported, evaluative HRQOL measure to assess the impact of burn scarring in children and adults. METHOD Semi-structured interviews, content validation surveys, and cognitive interviews were used to develop and test content validity of a new measure - the Brisbane Burn Scar Impact Profile (BBSIP). RESULTS Participants comprised Australian adults (n=23) and children (n=19) with burn scarring; caregivers of children with burn scarring (n=28); and international scar management experts (n=14). Items distinct from other burn scar measures emerged. Four versions of the BBSIP were developed; one for children aged 8-18 years, one for adults, one for caregivers (as proxies for children aged less than 8-years), and one for caregivers of children aged 8-18 years. Preliminary content validity of the BBSIP was supported. Final items covered physical and sensory symptoms; emotional reactions; impact on social functioning and daily activities; impact of treatment; and environmental factors. CONCLUSION The BBSIP was developed to assess burn-scar specific HRQOL and will be available at http://www.coolburns.com.au under a creative commons license. Further testing is underway.

Are organisations prepared for e-health implementation to respond to pandemic influenza?

E-health can facilitate communication and interactions among stakeholders involved in pandemic responses. Its implementation, nevertheless, represents a disruptive change in the healthcare workplace. Organisational preparedness assessment is an essential requirement prior to e-health implementation; including this step in the planning process can increase the chances of programme success. The objective of this study is to develop an e-health preparedness assessment model for pandemic influenza (EHPM4P). Following the Analytic Hierarchy Process (AHP), 20 contextual interviews were conducted with domain experts from May to September 2010. We examined the importance of all preparedness components within a fivedimensional hierarchical framework that was recently published. We also calculated the relative weight for each component at all levels of the hierarchy. This paper presents the hierarchical model (EHPM4P) that can be used to precisely assess healthcare organisational and providers' preparedness for e-health implementation and potentially maximise e-health benefits in the context of an influenza pandemic. Copyright © 2013 Inderscience Enterprises Ltd.

An eroding social justice agenda: The case of physical education and health edu-business in schools

In this paper we draw on current research to explore notions of a socially just Health and Physical Education (HPE), in light of claims that a neoliberal globalisation promotes markets over the states, and a new individualism that privileges self-interest over the collective good. We also invite readers to consider United Nations Educational, Scientific and Cultural Organization’s ambition for PE in light of preliminary findings from an Australian led research project exploring national and international patterns of outsourcing HPE curricula. Data were sourced from this international research project through a mixed method approach. Each external provider engaged in four phases of research activity: (a) Web-audits, (b) Interviews with external providers, (c) Network diagrams, and (d) School partner interviews and observations. Results We use these data to pose what we believe to be three emerging lines of inquiry and challenge for a socially just school HPE within neoliberal times. In particular our data indicates that the marketization of school HPE is strengthening an emphasis on individual responsibility for personal health, elevating expectations that schools and teachers will “fill the welfare gap” and finally, influencing the nature and purchase of educative HPE programs in schools. The apparent proliferation of external providers of health work, HPE resources and services reflects the rise and pervasiveness of neoliberalism in education. We conclude that this global HPE landscape warrants attention to investigate the extent to which external providers’ resources are compatible with schooling’s educative and inclusive mandates.

Women's health and a framework convention on global health

This paper considers the role for a Framework Convention on Global Health in addressing key challenges in women’s health at a global level. Part I analyses the conceptualization of health in terms of human rights and the linking of women’s rights and human rights. Part II seeks to identify pressing issues for women’s health, articulating 10 key challenges for women’s health. Part III considers the proposal for a Framework Convention on Global Health to meet global health needs. Finally, Part IV asks whether international law can provide a valuable platform to support recognition and achievement of women’s health rights and identifies key elements for supporting and promoting women’s health.

IMPOSE (IMProving Outcomes after Sepsis)—the effect of a multidisciplinary follow-up service on health-related quality of life in patients postsepsis syndromes—a double-blinded randomised controlled trial: protocol

Introduction Patients post sepsis syndromes have a poor quality of life and a high rate of recurring illness or mortality. Follow-up clinics have been instituted for patients postgeneral intensive care but evidence is sparse, and there has been no clinic specifically for survivors of sepsis. The aim of this trial is to investigate if targeted screening and appropriate intervention to these patients can result in an improved quality of life (Short Form 36 health survey (SF36V.2)), decreased mortality in the first 12 months, decreased readmission to hospital and/or decreased use of health resources. Methods and analysis 204 patients postsepsis syndromes will be randomised to one of the two groups. The intervention group will attend an outpatient clinic two monthly for 6 months and receive screening and targeted intervention. The usual care group will remain under the care of their physician. To analyse the results, a baseline comparison will be carried out between each group. Generalised estimating equations will compare the SF36 domain scores between groups and across time points. Mortality will be compared between groups using a Cox proportional hazards (time until death) analysis. Time to first readmission will be compared between groups by a survival analysis. Healthcare costs will be compared between groups using a generalised linear model. Economic (health resource) evaluation will be a within-trial incremental cost utility analysis with a societal perspective. Ethics and dissemination Ethical approval has been granted by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee (HREC; HREC/13/QRBW/17), The University of Queensland HREC (2013000543), Griffith University (RHS/08/14/HREC) and the Australian Government Department of Health (26/2013). The results of this study will be submitted to peer-reviewed intensive care journals and presented at national and international intensive care and/or rehabilitation conferences.