Comments on: "The role of the social environment in psychiatric research: Outstanding challenges and future directions by Dana March, James Kirkbride, Wim Veling"

On 17 March 2009, we hosted a live discussion of fresh new ideas in the epidemiology of schizophrenia. Discussion leaders Dana March of Columbia University, James Kirkbride of the University of Cambridge, and Wim Veling of Parnassia Psychiatric Institute delivered a wide-ranging discussion of social factors such as migration, ethnicity, and urbanicity, but also asked how this research could benefit from genetic insights. Finally, they discussed possible biological mechanisms that might transduce social factors into psychosis

Theories of moral education and implementation in Indonesia: Re-energizing cultural identity and addressing future challenges

School is regarded as a site of moral training for the younger generation to encounter nation’s future challenges as well as to re-energize nation’s cultural identity. The more competitive global society led by free market trade in terms of ASEAN Economic Community (AEC), requires the school to adapt and change its curriculum more frequently. Like many other countries, Indonesian Ministry of Education and Culture has introduced and nurtured universal values and traditional values respectively through school curriculum reforms to develop students’ ability to participating in global society. This paper will describe classical and contemporary theories related to moral education that have been implemented in Indonesia’s school curriculum and school activities. The theories developed by Durkheim, Alastair MacIntyre, and Basil Bernstein will be discussed. This includes explaining how far the theories have been adopted in Indonesia and how the approaches are currently being used in Indonesian schooling. This paper suggests despite the implementation of those theories in Indonesian schools, the government needs to optimise the operation of those theories to gain significant outcomes.

In bed with technology: Challenges and opportunities for sleep tracking

In recent years a variety of mobile apps, wearable technologies and embedded systems have emerged that allow individuals to track the amount and the quality of their sleep in their own beds. Despite the widespread adoption of these technologies, little is known about the challenges that current users face in tracking and analysing their sleep. Hence we conducted a qualitative study to examine the practices of current users of sleep tracking technologies and to identify challenges in current practice. Based on data collected from 5 online forums for users of sleep-tracking technologies, we identified 22 different challenges under the following 4 themes: tracking continuity, trust, data manipulation, and data interpretation. Based on these results, we propose 6 design opportunities to assist researchers and practitioners in designing sleep-tracking technologies.

Psychosocial presentation of revisional LAGB patients: A qualitative study

This qualitative study offers insight into the experiences, expectations, perceptions and beliefs that may lead to laparoscopic adjustable gastric band patients’ failure to achieve expected weight loss and seek revisional bariatric surgery. The 23 participants from two sites were interviewed and data were analysed from a grounded theory methodology in order to build a causal model. Analysis of participants’ reports identified ‘unrealistic expectations of the LAGB’ as the core category. Additionally, the restriction of the band had a negative impact on participants’ social interactions, leading to feelings of deprivation and, thus, to a desire for reward from food choices and consequently an increase of consumption of high-calorie-dense foods. These foods were chosen because of their specific texture or ability to provide reward. The resulting increase in weight or failure to achieve excess weight loss, led to feelings of shame and loneliness and emotional eating resulting in increased the consumption of rewarding foods. Thus, identifying unrealistic expectations of laparoscopic adjustable gastric band (LAGB) and emotional eating behaviours are important in those who are present initially for primary bariatric and revisional bariatric surgery, as they may contribute specifically to these patients’ weight regain and consequent failure to achieve excess weight loss.

Benefits and challenges of antivirulence antimicrobials at the dawn of the post-antibiotic era

In April 2014, the World Health Organization announced the beginning of a post-antibiotic era and declared antimicrobial resistance (AMR) a public health priority demanding global action. If no action is taken, by 2050 AMR will kill more people each year than cancer, with 10 million estimated annual deaths at a cost of $100 trillion to the global economy. New therapies to tackle multidrug resistant bacterial pathogens are urgently needed. Unlike traditional antibiotics, antivirulence drugs inhibit bacterial virulence instead of growth promising to offer a new class of superior therapeutics that will be ‘evolution-proof’ and ‘tailored-spectrum’. This mini-review discusses the latest emerging evidence on the promised benefits of antivirulence drugs over conventional antibiotics, also highlighting the challenges in evaluating these properties for each of the diverse virulence targets that are currently under investigation. The author argues that overcoming such challenges early in the development process constitutes an important step towards successfully progressing each of the expanding number of antivirulence strategies into next-generation therapies for common human and animal infections that are becoming increasingly refractory to all available antibiotics.

Brief for GSDR - Emerging Contaminants in urban stormwater: Challenges and perspectives for sustainable water use

Emerging contaminants (ECs) are chemical compounds commonly present in water. It is only recently that this family of compounds is being recognized as significant water pollutants (. ECs include a wide variety of chemicals such as pharmaceutical and personal care products (PPCPs), pesticides, hydrocarbons and hormones, among others, that once released into the environment exert adverse impacts on the human and wildlife endocrine system. Natural attenuation and conventional treatment processes are not capable of removing these micro-pollutants detected in wastewater influent and effluent and surface and drinking water. The main challenges related with presence of ECs in stormwater in the context of reuse are: a) Development of suitable laboratory test methodologies and protocols for ECs identification and quantification b) Identification of the sources of ECs in the urban environment; c) Understanding their impacts on human and/or ecosystem health; and d). Development of cost-effective removal technologies which are appropriate for large as well as small-scale application.

New directions: Air pollution challenges for developing megacities like Delhi

Most major cities around the world experience periods of elevated air pollution levels, which exceed international health-based air quality standards (Kumar et al., 2013). Although it is a global problem, some of the highest air pollution levels are found in rapidly expanding cities in India and China. The sources, emissions, transformations and broad effects of meteorology on air pollution are reasonably well accounted in air quality control strategies in many developed cities; however these key factors remain poorly constrained in the growing cities of countries with emerging economies. We focus here on Delhi, one of the largest global population centres, which faces particular air pollution challenges, now and in the future.

"Why are you crying? You got what you wanted!": Psychosocial experiences of sex reassignment surgery

Little is known about the psychosocial needs of trans individuals as they make the surgical transition to their preferred gender. This qualitative study explored the lived experiences of 14 Australian trans men and women, aged between 25 and 78 who had undergone sex reassignment surgery to determine if their needs were met. The key findings suggest that while the surgery met their personal needs, there are inconsistencies in the level of care and support provided at the medical level throughout the transition process. In legal terms, the complex legislative framework does little but increase the psychosocial burden of Australian trans people.

A psychosocial analysis of parent's decisions for limiting their young child's screen time: An examination of attitudes, social norms and roles, and control perceptions

- Objectives Preschool-aged children spend substantial amounts of time engaged in screen-based activities. As parents have considerable control over their child's health behaviours during the younger years, it is important to understand those influences that guide parents' decisions about their child's screen time behaviours. - Design A prospective design with two waves of data collection, 1 week apart, was adopted. - Methods Parents (n = 207) completed a Theory of Planned Behaviour (TPB)-based questionnaire, with the addition of parental role construction (i.e., parents' expectations and beliefs of responsibility for their child's behaviour) and past behaviour. A number of underlying beliefs identified in a prior pilot study were also assessed. - Results The model explained 77% (with past behaviour accounting for 5%) of the variance in intention and 50% (with past behaviour accounting for 3%) of the variance in parental decisions to limit child screen time. Attitude, subjective norms, perceived behavioural control, parental role construction, and past behaviour predicted intentions, and intentions and past behaviour predicted follow-up behaviour. Underlying screen time beliefs (e.g., increased parental distress, pressure from friends, inconvenience) were also identified as guiding parents' decisions. - Conclusion Results support the TPB and highlight the importance of beliefs for understanding parental decisions for children's screen time behaviours, as well as the addition of parental role construction. This formative research provides necessary depth of understanding of sedentary lifestyle behaviours in young children which can be adopted in future interventions to test the efficacy of the TPB mechanisms in changing parental behaviour for their child's health.

Grand challenges for public health

What is the future for public health in the twenty-first century? Can we glean an idea about the future of public health from its past? As Winston Churchill once said: ‘[T]he further backward you look, the further forward you can see.’ What can we see in the history of public health that gives us an idea of where public health might be headed in the future? (Gruszin et al. 2012). In the twentieth century there was substantial progress in public health in Australia. These improvements were brought about through a number of factors. In part, improvements were due to increasing knowledge about the natural history of disease and its treatment. Added to this knowledge was a shifting focus from legislative measures to protect health, to the emergence of improved promotion and prevention strategies, and a general improvement in social and economic conditions for people living in countries such as Australia. Gruszin et al. (2012) consider the range of social and economic reforms of the twentieth century as the most important determinants of the public’s health at the start of the twenty-first century (Gruszin et al. 2012 p 201). The same could not, however, be said for second or third world countries, many of whom have the most fundamental of sanitary and health protection issues still to deal with. For example, in sub-Saharan Africa and in Russia the decline in life expectancy can be said to be related to a range of interconnected factors. In Russia, issues such as alcoholism, violence, suicide, accidents and cardiovascular disease could be contributing to the falling life expectancy (McMichael & Butler 2007). In sub-Saharan Africa, a range of factors, such as HIV/AIDS, poverty, malaria, tuberculosis, undernutrition, totally inadequate infrastructure, gender inequality, conflict and violence, political taboos and a complete lack of political will, have all contributed to a dramatic drop in life expectancy (McMichael & Butler 2007).

Addressing the challenges of road safety in India: Are there lessons from Australia?

An invited panel presentation on "Road Safety: Challenges and Way outs" Overview - Road trauma trends in Australia - Key features of Australia’s approach to road safety - Role of university-based research centres in promoting road safety in Australia - UN Decade of Action for Road Safety

Twitter as a first draft of the present – and the challenges of preserving it for the future

This paper provides a framework for understanding Twitter as a historical source. We address digital humanities scholars to enable the transfer of concepts from traditional source criticism to new media formats, and to encourage the preservation of Twitter as a cultural artifact. Twitter has established itself as a key social media platform which plays an important role in public, real-time conversation. Twitter is also unique as its content is being archived by a public institution (the Library of Congress). In this paper we will show that we still have to assume that much of the contextual information beyond the pure tweet texts is already lost, and propose additional objectives for preservation.

Australian fly-in, fly-out operations: Impacts on communities, safety workers and their families

Background Australia’s mineral, resource and infrastructure sectors continues to expand as operations in rural and remote locations increasingly rely on fly-in, fly-out or drive-in, drive-out workforces in order to become economically competitive. The issues in employing these workforces are becoming more apparent and include a range of physical, mental, psychosocial, safety and community challenges. Objectives This review aims to consolidate a range of research conducted to communicate potential challenges for industry in relation to a wide variety of issues when engaging and using FIFO/DIDO workforces which includes roster design, working hours, fatigue, safety performance, employee wellbeing, turnover, psychosocial relationships and community concerns. Methods A wide literature review was performed using EBSCOhost and Google Scholar, with a focus on FIFO or DIDO workforces engaged within the resources sector. Results A number of existing gaps in the management of FIFO workforces and potential for future research were identified. This included the identification of various roster designs and hours worked across the resources industry and how to best understand the influences of roster swings, and work hours on fatigue, safety, psychological wellbeing and job satisfaction. Fatigue management, particularly in relation to travelling after extended work shifts can increase the risk for road safety and influence safety performance while at work due to a culmination of long hours, roster cycle and accumulated sleep debt. Further challenges associated with the engagement of this workforce include feelings of isolation, physiological and general health and lifestyle concerns. Conclusions FIFO workforces appear to be at an increased risk physically and mentally due to a wide range of influences of this unique lifestyle, particularly in relation to rosters, length of shift and feelings of community disengagement. Research and data collected has been limited in understanding the influences on employee engagement, satisfaction, retention and safety. Ensuring the challenges associated with FIFO employment are understood, addressed and communicated to workers and their families may assist.