Vitamin D and sun protection : the impact of mixed public health messages in Australia

Exposure of the skin to sunlight can cause skin cancer and is also necessary for cutaneous vitamin D production. Media reports have highlighted the purported health benefits of vitamin D. Our aim was to examine attitudes and behaviours related to sun protection and vitamin D. A cross-sectional study of 2,001 residents in Queensland, Australia aged 20-70 years was undertaken. Information collected included: skin cancer risk factors; perceptions about levels of sun exposure required to maintain vitamin D; belief that sun protection increases risk of vitamin D deficiency; intention, and actual change in sun protection practices for adults and children. Multivariate models examined predictors of attitudinal and behavioural change. One-third (32%) believed a fair-skinned adult, and 31% thought a child required at least 30 minutes per day in summer sun to maintain vitamin D levels. Reductions in sun protection were reported by 21% of adults and 14% of children. Factors associated with belief that sun protection may result in not obtaining enough vitamin D included aged ≥ 60 years (OR=1.35, 95% CI 1.09-1.66) and having skin that tanned easily (OR=1.96, 95% CI 1.38-2.78). Participants from low income households, and those who frequently used sun protective clothing were more likely to have reduced sun protection practices (OR=1.33, 95% CI 1.10-1.73 and OR=1.73, 95% CI 1.36-2.20, respectively). This study provides evidence of reductions in sun protection practices in a population living in a high UV environment. There is an urgent need to re-focus messages regarding sun exposure and for continued sun protection practices.

Motivation and perception factors influence buying home behaviour in Dilly, East Timor

Demand of low cost housing increased from 1995 to 1997 which is shown by the number of housing loan approval. In order to develop the most suitable marketing plan, developer needs to know some factors which influenced to the decision making process of buying house. This research used a residential development in PT Delta Comoro Permai, Dilly as a case study. A survey to homeowners has been done to evaluate the motivation and perception factors in buying home behaviour. The survey has been done on the 3rd August to 29th August 1998. In this study, four main components have been examined. Physical and linkage are not as important as environment and utilities for the homebuyer. Moreover, the result is consistent with developer’s motto ‘clean, secure, aesthetic, healthy and prosperity’. This study provides further recommendation in the environment and utilities components for the new development in the future.

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.

International comparisons of Malaysian construction labour productivity

Productivity is basic statistical information for many international comparisons and country performance assessments. This study estimates the construction labour productivity of 79 selected economies. The real (purchasing power parities converted) and nominal construction expenditure from the Report of 2005 International Comparison Programme published by the World Bank and construction employment from the database of labour statistics (LABORSTA) operated by the Bureau of Statistics of International Labour Organization were used in the estimation. The inference statistics indicate that the descending order of nominal construction labour productivity from high income economies to low income economies is not established. The average construction labour productivity of low income economies is higher than middle income economies when the productivity calculation uses purchasing power parities converted data. Malaysia ranked 50th and 63rd position among the 79 selected economies on real and nominal measurement respectively.

Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes

Socio-economic gradients in cardiovascular disease (CVD) and diabetes have been found throughout the developed world and there is some evidence to suggest that these gradients may be steeper for women. Research on social gradients in biological risk factors for CVD and diabetes has received less attention and we do not know the extent to which gradients in biomarkers vary for men and women. We examined the associations between two indicators of socio-economic position (education and household income) and biomarkers of diabetes and cardiovascular disease (CVD) for men and women in a national, population-based study of 11,247 Australian adults. Multi-level linear regression was used to assess associations between education and income and glucose tolerance, dyslipidaemia, blood pressure (BP) and waist circumference before and after adjustment for behaviours (diet, smoking, physical activity, TV viewing time, and alcohol use). Measures of glucose tolerance included fasting plasma glucose and insulin and the results of a glucose tolerance test (2 h glucose) with higher levels of each indicating poorer glucose tolerance. Triglycerides and High Density Lipoprotein (HDL) Cholesterol were used as measures of dyslipidaemia with higher levels of the former and lower levels of the later being associated with CVD risk. Lower education and low income were associated with higher levels of fasting insulin, triglycerides and waist circumference in women. Women with low education had higher systolic and diastolic BP and low income women had higher 2 h glucose and lower HDL cholesterol. With only one exception (low income and systolic BP), all of these estimates were reduced by more than 20% when behavioural risk factors were included. Men with lower education had higher fasting plasma glucose, 2 h glucose, waist circumference and systolic BP and, with the exception of waist circumference, all of these estimates were reduced when health behaviours were included in the models. While low income was associated with higher levels of 2-h glucose and triglycerides it was also associated with better biomarker profiles including lower insulin, waist circumference and diastolic BP. We conclude that low socio-economic position is more consistently associated with a worse profile of biomarkers for CVD and diabetes for women.

Social clubs and social capital : the effect of electronic gaming machines in disadvantaged regions on the creation or destruction of community resilience

The role of particular third sector organisations, Social Clubs, in supporting gambling through the use of EGMs in venues presents as a difficult social issue. Social Clubs gain revenue from gambling activities; but also contribute to social well-being through the provision of services to communities. The revenues derived from gambling in specific geographic locales has been seen by government as a way to increase economic development particularly in deprived areas. However there are also concerns about accessibility of low-income citizens to Electronic Gaming Machines (EGMS) and the high level of gambling overall in these deprived areas. We argue that social capital can be viewed as a guard against deleterious effects of unconstrained use of EGM gambling in communities. However, it is contended that social capital may also be destroyed by gambling activity if commercial business actors are able to use EGMs without community obligations to service provision. This paper examines access to gambling through EGMs and its relationship to social capital and the consequent effect on community resilience, via an Australian case study. The results highlight the potential two-way relationship between gambling and volunteering, such that volunteering (and social capital more generally) may help protect against problems of gambling, but also that volunteering as an activity may be damaged by increased gambling activity. This suggests that, regardless of the direction of causation, it is necessary to build up social capital via volunteering and other social capital activities in areas where EGMS are concentrated. The study concludes that Social Clubs using EGMs to derive funds are uniquely positioned within the community to develop programs that foster social capital creation and build community resilience in deprived areas.

The variant concept of transportation disadvantaged : evidence from Aydin, Turkey and Yamaga, Japan

Transportation disadvantaged groups, in the previous studies, are defined as those who are low income earners, family dependent, limited access to private motor vehicles and public transport services, and also those who oblige to spend relatively more time and money on their trips. Additionally those disable, young and elderly are considered among the natural groups of transportation disadvantaged. Although in general terms this definition seems correct, it is not specific enough to become a common universal definition that could apply to all urban contexts. This paper investigates whether travel difficulty perceptions vary and so does the definition of transportation disadvantaged in socio-culturally different urban contexts. For this investigation the paper undertakes a series of statistical analysis in the case study of Yamaga, Japan, and compares the findings with a previous case study, where the same methodology, hypothesis, and assumptions were utilized in a culturally and demographically different settlement of Aydin, Turkey. After comparing the findings observed in Aydin with the statistical analysis results of Yamaga, this paper reveals that there can be no explicitly detailed universal definition of transportation disadvantaged. The paper concludes by stating characteristics of transportation disadvantage is not globally identical, and policies and solutions that work in a locality may not show the same results in another socio-cultural context.

Weekly activity-travel behaviour in rural Northern Ireland : differences by context and socio-demographic

Despite a wide variation in access to goods and services between rural areas, common policy interventions are often proposed in Northern Ireland. Questions remain as to the level and form of policy differentiation that is required, if any, both within and between different rural areas. This issue is investigated in this paper through the analysis of activity-travel patterns of individuals living in two rural areas with different levels of area accessibility and area mobility. Three focus groups, 299 questionnaires and 89 activity-travel diaries for 7 days were collected for individuals from these areas. Regression analyses were employed to explore the degree to which different factors influence activity travel behaviour. The results indicate that individuals from rural areas with a higher level of accessibility are more integrated within their local community and as a result, are potentially less at risk of being excluded from society due to immobility. Differences, however, were also found between different groups within an area (e.g. non-car owning individuals who were more reliant on walking, and low-income individuals who made trips of a shorter distance). Based on the study findings and a review of existing policies, this research highlights the need to tailor policy responses to reflect the particular sets of circumstances exhibited in different areas.

Rural activity spaces and transport disadvantage : qualitative analysis of quantitative models integrating time and space

Current knowledge about the relationship between transport disadvantage and activity space size is limited to urban areas, and as a result, very little is known to date about this link in a rural context. In addition, although research has identified transport disadvantaged groups based on their size of activity spaces, these studies have, however, not empirically explained such differences and the result is often a poor identification of the problems facing disadvantaged groups. Research has shown that transport disadvantage varies over time. The static nature of analysis using the activity space concept in previous research studies has lacked the ability to identify transport disadvantage in time. Activity space is a dynamic concept; and therefore possesses a great potential in capturing temporal variations in behaviour and access opportunities. This research derives measures of the size and fullness of activity spaces for 157 individuals for weekdays, weekends, and for a week using weekly activity-travel diary data from three case study areas located in rural Northern Ireland. Four focus groups were also conducted in order to triangulate the quantitative findings and to explain the differences between different socio-spatial groups. The findings of this research show that despite having a smaller sized activity space, individuals were not disadvantaged because they were able to access their required activities locally. Car-ownership was found to be an important life line in rural areas. Temporal disaggregation of the data reveals that this is true only on weekends due to a lack of public transport services. In addition, despite activity spaces being at a similar size, the fullness of activity spaces of low-income individuals was found to be significantly lower compared to their high-income counterparts. Focus group data shows that financial constraint, poor connections both between public transport services and between transport routes and opportunities forced individuals to participate in activities located along the main transport corridors.

The limits of competition : reasserting a role for consumer protection and fair trading regulation in competitive markets

In this paper we advocate for the continued need for consumer protection and fair trading regulation, even in competitive markets. For the purposes of this paper a ‘competitive market’ is defined as one that has low barriers to entry and exit, with homogenous products and services and numerous suppliers. Whilst competition is an important tool for providing consumer benefits, it will not be sufficient to protect at least some consumers, particularly vulnerable, low income consumers. For this reason, we argue, setting competition as the ‘end goal’ and assuming that consumer protection and consumer benefits will always follow, is a flawed regulatory approach. The ‘end goal’ should surely be consumer protection and fair markets, and a combination of competition law and consumer protection law should be applied in order to achieve those goals.

Interest rate caps : protection or paternalism

In a context where over-indebtedness and financial exclusion have been recognised as problems in Australia, it is undesirable that those who can least afford it, pay a high cost for short-term consumer credit. Evidence points to an increase in consumer debt in Australia and consequential over-indebtedness which has been shown to lead to a wide range of social problems.2 There is also evidence of financial exclusion, where consumers suffer a lack of access to mainstream financial services, and in Australia this is particularly the case with regard to access to safe and affordable credit.3 Financial exclusion can only exacerbate over-indebtedness, given that financially excluded, predominantly low income consumers , have been shown to turn to high cost credit to meet their short term credit needs. This is a problem that has been explored most recently in the Victorian Consumer Credit Review...

Analysis of rural activity spaces and transport disadvantage using a multi-method approach

Current knowledge about the relationship between transport disadvantage and activity space size is limited to urban areas, and as a result, very little is known about this link in a rural context. In addition, although research has identified transport disadvantaged groups based on their size of activity space, these studies have, however, not empirically explained such differences and the result is often a poor identification of the problems facing disadvantaged groups. Research has shown that transport disadvantage varies over time. The static nature of analysis using the activity space concept in previous research studies has lacked the ability to identify transport disadvantage in time. Activity space is a dynamic concept; and therefore possesses a great potential in capturing temporal variations in behaviour and access opportunities. This research derives measures of the size and fullness of activity spaces for 157 individuals for weekdays, weekends, and for a week using weekly activity-travel diary data from three case study areas located in rural Northern Ireland. Four focus groups were also conducted in order to triangulate quantitative findings and to explain the differences between different socio-spatial groups. The findings of this research show that despite having a smaller sized activity space, individuals were not disadvantaged because they were able to access their required activities locally. Car-ownership was found to be an important life line in rural areas. Temporal disaggregation of the data reveals that this is true only on weekends due to a lack of public transport services. In addition, despite activity spaces being at a similar size, the fullness of activity spaces of low-income individuals was found to be significantly lower compared to their high-income counterparts. Focus group data shows that financial constraint, poor connections both between public transport services and between transport routes and opportunities forced individuals to participate in activities located along the main transport corridors.

Chinese driver perceptions about speeding and traffic law enforcement

The World Health Organisation has highlighted the urgent need to address the escalating global public health crisis associated with road trauma. Low-income and middle-income countries bear the brunt of this, and rapid increases in private vehicle ownership in these nations present new challenges to authorities, citizens, and researchers alike. The role of human factors in the road safety equation is high. In China, human factors have been implicated in more than 90% of road crashes, with speeding identified as the primary cause (Wang, 2003). However, research investigating the factors that influence driving speeds in China is lacking (WHO, 2004). To help address this gap, we present qualitative findings from group interviews conducted with 35 Beijing car drivers in 2008. Some themes arising from data analysis showed strong similarities with findings from highly-motorised nations (e.g., UK, USA, and Australia) and include issues such as driver definitions of ‘speeding’ that appear to be aligned with legislative enforcement tolerances, factors relating to ease/difficulty of speed limit compliance, and the modifying influence of speed cameras. However, unique differences were evident, some of which, to our knowledge, are previously unreported in research literature. Themes included issues relating to an expressed lack of understanding about why speed limits are necessary and a perceived lack of transparency in traffic law enforcement and use of associated revenue. The perception of an unfair system seemed related to issues such as differential treatment of certain drivers and the large amount of individual discretion available to traffic police when administering sanctions. Additionally, a wide range of strategies to overtly avoid detection for speeding and/or the associated sanctions were reported. These strategies included the use of in-vehicle speed camera detectors, covering or removing vehicle licence number plates, and using personal networks of influential people to reduce or cancel a sanction. These findings have implications for traffic law, law enforcement, driver training, and public education in China. While not representative of all Beijing drivers, we believe that these research findings offer unique insights into driver behaviour in China.

Imagination for re-engagement from the margins of education

For marginalised secondary school students, mainstream education may no longer appear to be an inviting place. While proposed solutions to problems of disengagement and marginalisation appear to concentrate on finding ways to coerce students back to mainstream education through, for example, ‘learning or earning’ legislation, this article suggests that more effective solutions may be found by engaging with the students in the margins that they occupy. Following discussion of key influences on student disengagement and a theory of imaginations, a ‘students-as-researchers’ (SaR) model of working with young people is discussed to demonstrate that, through the scaffolded application of active imagination, it is possible for such students to identify and create their own connections to the mainstream. The SaR model is illustrated through reference to groups of disaffected high school students who participated in an action research project to investigate apparent low aspiration for tertiary education among their peers at schools serving low-income communities in Queensland, Australia.