Health consequences of exposure to e-waste : a systematic review

Background The population exposed to potentially hazardous substances through inappropriate and unsafe management practices related to disposal and recycling of end-of-life electrical and electronic equipment, collectively known as e-waste, is increasing. We aimed to summarise the evidence for the association between such exposures and adverse health outcomes. Methods We systematically searched five electronic databases (PubMed, Embase, Web of Science, PsycNET, and CINAHL) for studies assessing the association between exposure to e-waste and outcomes related to mental health and neurodevelopment, physical health, education, and violence and criminal behaviour, from Jan 1, 1965, to Dec 17, 2012, and yielded 2274 records. Of the 165 full-text articles assessed for eligibility, we excluded a further 142, resulting in the inclusion of 23 published epidemiological studies that met the predetermined criteria. All studies were from southeast China. We assessed evidence of a causal association between exposure to e-waste and health outcomes within the Bradford Hill framework. Findings We recorded plausible outcomes associated with exposure to e-waste including change in thyroid function, changes in cellular expression and function, adverse neonatal outcomes, changes in temperament and behaviour, and decreased lung function. Boys aged 8–9 years living in an e-waste recycling town had a lower forced vital capacity than did those living in a control town. Significant negative correlations between blood chromium concentrations and forced vital capacity in children aged 11 and 13 years were also reported. Findings from most studies showed increases in spontaneous abortions, stillbirths, and premature births, and reduced birthweights and birth lengths associated with exposure to e-waste. People living in e-waste recycling towns or working in e-waste recycling had evidence of greater DNA damage than did those living in control towns. Studies of the effects of exposure to e-waste on thyroid function were not consistent. One study related exposure to e-waste and waste electrical and electronic equipment to educational outcomes. Interpretation Although data suggest that exposure to e-waste is harmful to health, more well designed epidemiological investigations in vulnerable populations, especially pregnant women and children, are needed to confirm these associations. Funding Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Australia.

Development of an education program to improve care of patients with dementia in an acute care setting

As the population ages, the number of people with dementia in acute care environments is projected to increase rapidly. However, many acute care nurses have undertaken little or no dementia training, potentially leading to reduced quality of care for these patients. This article details the development and delivery of a tailored education program to improve the quality of care of people with dementia in a large, urban hospital in Australia. Designed specifically for the existing context, environment and knowledge levels, the program was developed from multiple inputs, including: expert opinion, literature on workplace and dementia care training, and feedback from participants. The program was delivered to acute care nurses and allied health staff within an outcome based, microteaching model. The broader applicability of the development and delivery techniques used in this program is also discussed.

User preferences for text message-delivered skin cancer prevention and early detection

Evidence is needed for the acceptability and user preferences of receiving skin cancer-related text messages. We prepared 27 questions to evaluate attitudes, satisfaction with program characteristics such as timing and spacing, and overall satisfaction with the Healthy Text program in young adults. Within this randomised controlled trial (age 18-42 years), 546 participants were assigned to one of three Healthy Text message groups; sun protection, skin self-examination, or attention-control. Over a 12-month period, 21 behaviour-specific text messages were sent to each group. Participants’ preferences were compared between the two interventions and control group at the 12-month follow-up telephone interview. In all three groups, participants reported the messages were easy to understand (98%), provided good suggestions or ideas (88%), and were encouraging (86%) and informative (85%) with little difference between the groups. The timing of the texts was received positively (92%); however, some suggestions for frequency or time of day the messages were received from 8% of participants. Participants in the two intervention groups found their messages more informative, and triggering behaviour change compared to control. Text messages about skin cancer prevention and early detection are novel and acceptable to induce behaviour change in young adults.

Multi-modal deformable medical image registration

Non-rigid image registration is an essential tool required for overcoming the inherent local anatomical variations that exist between images acquired from different individuals or atlases. Furthermore, certain applications require this type of registration to operate across images acquired from different imaging modalities. One popular local approach for estimating this registration is a block matching procedure utilising the mutual information criterion. However, previous block matching procedures generate a sparse deformation field containing displacement estimates at uniformly spaced locations. This neglects to make use of the evidence that block matching results are dependent on the amount of local information content. This paper presents a solution to this drawback by proposing the use of a Reversible Jump Markov Chain Monte Carlo statistical procedure to optimally select grid points of interest. Three different methods are then compared to propagate the estimated sparse deformation field to the entire image including a thin-plate spline warp, Gaussian convolution, and a hybrid fluid technique. Results show that non-rigid registration can be improved by using the proposed algorithm to optimally select grid points of interest.

Linking pedagogical knowledge practices and student outcomes in STEM education for primary schools

STEM education is a new frontier in Australia, particularly for primary schools. However, the E in STEM needs to have a stronger focus with science and mathematics concepts aligned to the presiding curricula. In addition, pedagogical knowledge practices such as planning, preparation, teaching strategies, assessment and so forth need to be connected to key concepts for developing a STEM education. One of the aims of this study was to understand how a pedagogical knowledge practice framework could be linked to student outcomes in STEM education. Specifically, this qualitative research investigated Year 4 students’ involvement in an integrated STEM education program that focused on science concepts (e.g., states of matter, testing properties of materials) and mathematics concepts (such as 3D shapes and metric measurements: millilitres, temperature, grams, centimetres) for designing, making and testing a strong and safe medical kit to insulate medicines at desirable temperatures. Eleven pedagogical knowledge practices (e.g., planning, preparation, teaching strategies, classroom management, and assessment) were used as a framework for understanding how teaching may be linked to student outcomes in STEM education. For instance, “planning” involved devising a student booklet as a resource for students to understand the tasks required of them, which also provided space for them to record ideas, results and information. Planning involved linking national and state curriculum documents to the STEM education activities. More studies are required around pedagogical knowledge frameworks to understand what students learn when involved in STEM education, particularly with the inclusion of engineering education.

Patient perspectives of using a web based intervention program for patients with type 2 diabetes and acute coronary syndrome

Introduction Research highlights patients with dual diagnoses of type 2 diabetes and acute coronary syndrome (ACS) have higher readmission rates and poorer health outcomes than patients with singular chronic conditions. Despite this, there is a lack of education programs targeted for this dual diagnosis population to improve self-management and decrease negative health outcomes. There is evidence to suggest that internet based interventions may improve health outcomes for patients with singular chronic conditions, however there is a need to develop an evidence base for ACS patients with comorbid diabetes. There is a growing awareness of the importance of a participatory model in developing effective online interventions. That is, internet interventions are more effective if end users’ perceptions of the intervention are incorporated in their final development prior to testing in large scale trials. Objectives This study investigated patients’ perspectives of the web-based intervention designed to promote self-management of the dual conditions in order to refine the intervention prior to clinical trial evaluation. Methods An interpretive approach with thematic analysis was used to obtain deeper understanding regarding participants’ experience when using web-application interventions for patients with ACS and type 2 diabetes. Semi-structured interviews were undertaken on a purposive sample of 30 patients meeting strict inclusion and exclusion criteria to obtain their perspectives on the program. Results Preliminary results indicate patients with dual diagnoses express more complex needs than those with a singular condition. Participants express a positive experience with the proposed internet intervention and emerging themes include that the web page is seen as easy to use and comforting as a support, in that patients know they are not alone. Further results will be reported as they become available. Conclusion The results indicate potential for patient acceptability of the newly developed internet intervention for patients with ACS and comorbid diabetes. Incorporation of patient perspectives into the final development of the intervention is likely to maximise successful outcomes of any future trials that utilise this intervention. Future quantitative evaluation of the effectiveness of the intervention is being planned.

Increasing the confidence and knowledge of occupational therapy and physiotherapy students when communicating with people with aphasia: A pre–post intervention study

This study investigated occupational therapy and physiotherapy students' level of confidence and knowledge of strategies for communicating with people with aphasia (PWA) before and after a communication partner-training (CPT) program. Twenty-eight physiotherapy and occupational therapy students participated in a pre–post CPT program. Students completed a customized mixed-methods questionnaire before and after the intervention. The CPT program involved a lecture about effective communication strategies followed by a conversation with PWA to practice strategies learnt. Before CPT, students were not confident with the possibility of communicating with PWA. Students demonstrated rudimentary knowledge of supported conversation, identifying a maximum of five strategies for communicating effectively with PWA. Following intervention, students demonstrated increased confidence. Students' knowledge of effective communication strategies improved, with students identifying a maximum of 16 suitable strategies post-training. The results suggest that occupational therapy and physiotherapy students have potential to benefit from practical training in supported communication with PWA, which may assist them during placements in clinical settings with neurological patients or subsequent employment.

Bacterial adherence and biofilm formation on medical implants : a review

Biofilms are a complex group of microbial cells that adhere to the exopolysaccharide matrix present on the surface of medical devices. Biofilm-associated infections in the medical devices pose a serious problem to the public health and adversely affect the function of the device. Medical implants used in oral and orthopedic surgery are fabricated using alloys such as stainless steel and titanium. The biological behavior, such as osseointegration and its antibacterial activity, essentially depends on both the chemical composition and the morphology of the surface of the device. Surface treatment of medical implants by various physical and chemical techniques are attempted in order to improve their surface properties so as to facilitate bio-integration and prevent bacterial adhesion. The potential source of infection of the surrounding tissue and antimicrobial strategies are from bacteria adherent to or in a biofilm on the implant which should prevent both biofilm formation and tissue colonization. This article provides an overview of bacterial biofilm formation and methods adopted for the inhibition of bacterial adhesion on medical implants

Literacy report 2008 [2008 futureSACE School to Work Innovation Program]

This project was designed to support high school teachers in participating schools to work with students whose literacy proficiency in key elements of the literacy component of the Year 9 LaN tests were in the low bands. -- p. 5.

Indicator Bats Program: A System for the Global Acoustic Monitoring of Bats

Bats are an important component of mammalian biodiversity and fill such a wide array of ecological niches that they may offer an important multisensory bioindicator role in assessing ecosystem health. There is a need to monitor population trends of bats for their own sake because many populations face numerous environmental threats related to climate change, habitat loss, fragmentation, hunting, and emerging diseases. To be able to establish bat ultrasonic biodiversity trends as a reliable indicator, it is important to standardize monitoring protocols, data management, and analyses. This chapter discusses the main issues to be considered in developing a bat ultrasonic indicator. It focuses on the results from indicator bats program (iBats), a system for the global acoustic monitoring of bats, in Eastern Europe. Finally, the chapter reviews the strengths and weaknesses of the Program and considers the opportunities and threats that it may face in the future.

How to plan and implement an environmental education program for a conservation area : lessons from Australia and Borneo

The Augo Wetland Forest Park, along with other conservation areas around the world, provides an opportunity for a personal connection with the natural world - an opportunity for creating ways to convince people to reverse the degradation of the planet. In this presentation I use the settings approach, as used by the World Health Organisation in health promotion, as a framework. The WHO’s 1986 Ottawa Charter states that "Health is created and lived by people within the settings of their everyday life; where they learn, work, play, and love." I argue that, similarly, a conservation area provides a setting for people to connect with environmental issues and can be the place where positive behaviours and actions for the environment are created and enacted. In a wired and virtual world, such settings may be the only opportunity some people, especially children, get to connect with the environment. An evidence-based, intentionally designed and implemented environmental education program enhances the opportunities for the personal connection and subsequent action. Planning and implementing an Environmental education program for a conservation area requires an understanding of the principles of three domains: • Environmental Communication • Environmental Education • Environmental Interpretation In this presentation I define these domains and demonstrate how they become interdependent within the context of a particular setting such as a conservation area. I outline the principles of each domain and demonstrate how they can be enacted with reference to environmental education program case studies from settings in Australia and Borneo. The first case study is based around a proposal for a planned residential community at Eden’s Crossing, in Brisbane’s high growth Western corridor. The setting featured a number of important natural and heritage conservation characteristics and the developer wanted to be pro-active in informing the market what this development aims to achieve in terms of innovative community and environmental objectives. By designing an education and interpretation program in line with best practice education and interpretation principles the developers would be assisted in their efforts to build community, preserve heritage, and facilitate environmentally sensitive lifestyles for the future residents of Eden’s Crossing. Above all, the strategy focused on advancing sustainability in a way that made the Eden’s Crossing greenfield development significantly greener. It did this by interacting with prospective purchasers, and building knowledge about sustainability with a view to shaping the future community of Eden’s Crossing in terms of attitudes and behaviours. The second case study is based around the development of the Rainforest Interpretation Centre (RIC), now renamed the Rainforest Discovery Centre, an environmental education facility managed by the Sabah Forestry Department (SFD) and located at the edge of the Kabili-Sepilok Forest Reserve in the East Malaysian state of Sabah (Borneo). This setting is of paramount importance for biodiversity conservation and research and a vital habitat for orang utan. As an Environmental Education Consultant I was tasked with developing an environmental education program for this setting as part of the SFD’s long- term strategy towards sustainable forest management. By employing the principles of Environmental Education and Environmental Interpretation I designed and implemented a program with three major components: • an environmental education component for visiting primary and secondary school groups. • an environmental education component for in-service and pre-service teachers and teacher educators. • a public awareness and environmental interpretation component which caters for the general public and tourists. From these modest beginnings the program has expanded and new facilities have been developed to meet the demands of visitors, teachers and students. The effectiveness of the program can be traced back to the grounding in the principles of best practice environmental education, communication and interpretation.