Sustainable water provision : challenges, alternative strategies and sources in the era of climate change

As a result of rapid urbanisation, population growth, changes in lifestyle, pollution and the impacts of climate change, water provision has become a critical challenge for planners and policy-makers. In the wake of increasingly difficult water provision and drought, the notion that freshwater is a finite and vulnerable resource is increasingly being realised. Many city administrations around the world are struggling to provide water security for their residents to maintain lifestyle and economic growth. This chapter reviews the global challenge of providing freshwater to sustain lifestyles and economic growth, and the contributing challenges of climate change, urbanisation, population growth and problems in rainfall distribution. The chapter proceeds to evaluate major alternatives to current water sources such as conservation, recycling and reclamation, and desalination. Integrated water resource management is briefly looked at to explore its role in complementing water provision. A comparative study on alternative resources is undertaken to evaluate their strengths, weaknesses, opportunities and constraints, and the results are discussed.

Public-private partnerships in the promotion of sport and well-being : a governance model

This research focuses on exploring the links between sport, Indigenous self determination and deeper engagement within mainstream Australia especially with regard to the issue of promoting healthy lifestyles and the role of governance, through sport governance. Against all social, economic and health criteria Indigenous Australians are disadvantaged – despite government attention and financial input. It is well understood that education is a basis to better health, employment and lifestyle (Furneaux and Brown, 2008). However, many of the issues confronting Indigenous people have not responded to conventional government approaches based on program development and policy initiatives from single organisations (Ryan et al 2006). As a consequence, new approaches that both tap into the specific interests of Indigenous people and better engage them in the process of governance are required. The case material of the research focuses on the Australian Football League (AFL) Kickstart program.

Creating Active Futures : Edited Proceedings of the 26th ACHPER International Conference

Physical inactivity has become a major cause of the global increase in non-communicable disease (World Health Organisation, 2009}. In 2008, the World Economic Forum called for employers to be proactive in the prevention of non-communicable diseases in the workforce. A significant contributor to the development of a healthy workforce is a reliable pool of employees who are receptive to and aware of healthy lifestyle practices even before becoming employed. Health and Physical Education (HPE) is often stereotyped as 'doing sport'. However, if HPE is to play a part in the development of a healthy workforce, then the HPE learning environment must be about creating meaningful learning for all, which is clearly more than the creation of elite athletes. The ultimate aim of health and physical educators must be about 1) developing lifelong and habitual physical activity; 2) developing generic physical skills; 3) inspiring holistic and positive emotional attitudes and 4) instilling a focus on evidence based knowledge as a framework for inspiring active citizenship. As a response to the worldwide move to the development of healthier people, Australia currently has a strong momentum for an expanded and more unified role for HPE within a potential National curriculum. Other countries have engaged in such a process and much can be learned from their experiences of the process. The 2009 Australian Council for Health, Physical Education and Recreation (ACHPER) conference was a landmark conference that included an International group of experts from all continents and twenty three countries. Creating Active Futures: Edited Proceedings of the 26th ACHPER International Conference is an amalgamation of research and professional perspectives presented at the conference. The papers in this volume emerged from those presented for peer review, rather than through seeking specific articles. This volume is divided into sections based on the five conference themes: 1) Issues in Health and Physical Education (HPE) Pedagogy; 2) Practical Application of Science in HPE; 3) Lifestyle Enhancement; 4) Developing Sporting Excellence; 5) Contemporary Games Teaching. The 'Issues in HPE Pedagogy' section provides a diverse set of perspectives on teaching HPE with papers from a range of topics that include first aid, philosophy, access, cultural characteristics, methods and teaching styles, curriculum, qualifications and emotional development. The second section links science to teaching HPE and provides a range of valuable information on injury prevention, information technology, personality and skill development. Section 3 is a collection of writings and research about Lifestyle Enhancement. Topics include the important role of adventure, the natural world, curriculum, migrant viewpoints, beliefs and globally focused programs in the development of active citizens. The section on sporting excellence contains papers that undertake to explain an aspect of excellence in sport. The last section of this volume highlights some contemporary views on teaching games.

A longitudinal study of the relationship between lifestyle and mental health among midlife and older women in Australia : findings from the Healthy Aging of Women Study

We investigated the temporal relationship between lifestyle and mental health among 564 midlife women. The mental health measured included anxiety, depression, and mental well-being; the lifestyle measures included body mass index (BMI), exercise, smoking, alcohol use, and caffeine consumption. We found that BMI was positively related with mental well-being (r = .316, p = .009); smokers had lower mental well-being than nonsmokers (β = 6.725, p = .006), and noncaffeine drinkers had higher mental well-being (β = 5, p = .023). Past alcohol-drinkers had less anxiety than nondrinkers (β = 1.135, p = .04). Therefore, lifestyle is predictive of mental health among midlife and older women.

Associations among smoking status, lifestyle and lipoprotein subclasses

BACKGROUND: The relationship between cigarette smoking and cardiovascular disease is well established, yet the underlying mechanisms remain unclear. Although smokers have a more atherogenic lipid profile, this may be mediated by other lifestyle-related factors. Analysis of lipoprotein subclasses by the use of nuclear magnetic resonance spectroscopy (NMR) may improve characterisation of lipoprotein abnormalities. OBJECTIVE: We used NMR spectroscopy to investigate the relationships between smoking status, lifestyle-related risk factors, and lipoproteins in a contemporary cohort. METHODS: A total of 612 participants (360 women) aged 40–69 years at baseline (199021994) enrolled in the Melbourne Collaborative Cohort Study had plasma lipoproteins measured with NMR. Data were analysed separately by sex. RESULTS: After adjusting for lifestyle-related risk factors, including alcohol and dietary intake, physical activity, and weight, mean total low-density lipoprotein (LDL) particle concentration was greater for female smokers than nonsmokers. Both medium- and small-LDL particle concentrations contributed to this difference. Total high-density lipoprotein (HDL) and large-HDL particle concentrations were lower for female smokers than nonsmokers. The proportion with low HDL particle number was greater for female smokers than nonsmokers. For men, there were few smoking-related differences in lipoprotein measures. CONCLUSION: Female smokers have a more atherogenic lipoprotein profile than nonsmokers. This difference is independent of other lifestyle-related risk factors. Lipoprotein profiles did not differ greatly between male smokers and nonsmokers.

Lifestyle factors associated concurrently and prospectively with co-morbid cardiovascular disease in a population-based cohort of colorectal cancer survivors

Aims To assess self-reported lifetime prevalence of cardiovascular disease (CVD) among colorectal cancer survivors, and examine the cross-sectional and prospective associations of lifestyle factors with co-morbid CVD. Methods Colorectal cancer survivors were recruited (n = 1966). Data were collected at approximately 5, 12, 24 and 36 months post-diagnosis. Cross-sectional findings included six CVD categories (hypercholesterolaemia, hypertension, diabetes, heart failure, kidney disease and ischaemic heart disease (IHD)) at 5 months post-diagnosis. Longitudinal outcomes included the probability of developing (de novo) co-morbid CVD by 36 months post-diagnosis. Lifestyle factors included body mass index, physical activity, television (TV) viewing, alcohol consumption and smoking. Results Co-morbid CVD prevalence at 5 months post-diagnosis was 59%, and 16% of participants with no known CVD at the baseline reported de novo CVD by 36 months. Obesity at the baseline predicted de novo hypertension (odds ratio [OR] = 2.20, 95% confidence intervals [CI] = 1.09, 4.45) and de novo diabetes (OR = 6.55, 95% CI = 2.19, 19.53). Participants watching >4 h of TV/d at the baseline (compared with <2 h/d) were more likely to develop ischaemic heart disease by 36 months (OR = 5.51, 95% CI = 1.86, 16.34). Conclusion Overweight colorectal cancer survivors were more likely to suffer from co-morbid CVD. Interventions focusing on weight management and other modifiable lifestyle factors may reduce functional decline and improve survival.

An investigation of the relationship between subjective sleep quality, loneliness and mood in an Australian sample: Can daily routine explain the links?

Background: Loneliness and low mood are associated with significant negative health outcomes including poor sleep, but the strength of the evidence underlying these associations varies. There is strong evidence that poor sleep quality and low mood are linked, but only emerging evidence that loneliness and poor sleep are associated. Aims: To independently replicate the finding that loneliness and poor subjective sleep quality are associated and to extend past research by investigating lifestyle regularity as a possible mediator of relationships, since lifestyle regularity has been linked to loneliness and poor sleep. Methods: Using a cross-sectional design, 97 adults completed standardized measures of loneliness, lifestyle regularity, subjective sleep quality and mood. Results: Loneliness was a significant predictor of sleep quality. Lifestyle regularity was not a predictor of, nor associated with, mood, sleep quality or loneliness. Conclusions: This study provides an important independent replication of the association between poor sleep and loneliness. However, the mechanism underlying this link remains unclear. A theoretically plausible mechanism for this link, lifestyle regularity, does not explain the relationship between loneliness and poor sleep. The nexus between loneliness and poor sleep is unlikely to be broken by altering the social rhythm of patients who present with poor sleep and loneliness.

Prevalence and determinants of the health promotion and risk reduction practices of younger female survivors of breast cancer

This thesis describes a discrete component of a larger mixed-method (survey and interview) study that explored the health-promotion and risk-reduction practices of younger premenopausal survivors of ovarian, breast and haematological cancers. This thesis outlines my distinct contribution to the larger study, which was to: (1) Produce a literature review that thoroughly explored all longer-term breast cancer treatment outcomes, and which outlined the health risks to survivors associated with these; (2) Describe and analyse the health-promotion and risk-reduction behaviours of nine younger female survivors of breast cancer as articulated in the qualitative interview dataset; and (3) Test the explanatory power of the Precede-Proceed theoretical framework underpinning the study in relation to the qualitative data from the breast cancer cohort. The thesis reveals that breast cancer survivors experienced many adverse outcomes as a result of treatment. While they generally engaged in healthy lifestyle practices, a lack of knowledge about many recommended health behaviours emerged throughout the interviews. The participants also described significant internal and external pressures to behave in certain ways because of the social norms surrounding the disease. This thesis also reports that the Precede-Proceed model is a generally robust approach to data collection, analysis and interpretation in the context of breast cancer survivorship. It provided plausible explanations for much of the data in this study. However, profound sociological and psychological implications arose during the analysis that were not effectively captured or explained by the theories underpinning the model. A sociological filter—such as Turner’s explanation of the meaning of the body and embodiment in the social sphere (Turner, 2008)—and the psychological concerns teased out in Mishel’s (1990) Uncertainty in Illness Theory, provided a useful dimension to the findings generated through the Precede-Proceed model. The thesis concludes with several recommendations for future research, clinical practice and education in this context.

An investigation of consumer acceptance of M-banking

This paper aims to identify and test the key motivators and inhibitors for consumer acceptance of mobile phone banking (M-banking), particularly those that affect the consumer’s attitude towards, and intention to use, this self-service banking technology. A web-based survey was undertaken where respondents completed a questionnaire about their perceptions of M-banking’s ease of use, usefulness, cost, risk, compatibility with their lifestyle, and their need for interaction with personnel. Correlation and hierarchical multiple regression analysis, with Sobel tests, were used to determine whether these factors influenced consumers’ attitude and intention to use M-banking.

Queensland Aborigines, multiple realities and the social sources of suffering. Part 2: Suicide, spirits and symbolism

This is the second part of a paper that explores a range of magico-religious experiences such as immaterial voices and visions, in terms of local cultural, moral and socio-political circumstances in an Aboriginal town in rural Queensland. This part of the paper explores the political and cultural symbolism and meaning of suicide. It charts the saliency of suicide amongst two groups of kin and cohorts and the social meaningfulness and problematic of the voices and visions in relation to suicide, to identity and family forms and to funerals and a heavily drinking lifestyle. I argue that voices and visions are used to reinterpret social experience and to establish meaning and that tragically suicide evokes connectivity rather than anomie and here cannot be understood merely as an individualistic act or evidence of individual pathology. Rather it is about transformation and crossing a threshold to join an enduring domain of Aboriginality. In this life world, where family is the highest social value and where a relational view of persons holds sway, the individualistic practice of psychiatric and other helping professions, is a considerable problem.

Predicting the consumption of foods low in saturated fats among people diagnosed with Type 2 diabetes and cardiovascular disease. The role of planning in the theory of planned behaviour

The present study tested the utility of an extended version of the theory of planned behaviour that included a measure of planning, in the prediction of eating foods low in saturated fats among adults diagnosed with Type 2 diabetes and/or cardiovascular disease. Participants (N = 184) completed questionnaires assessing standard theory of planned behaviour measures (attitude, subjective norm, and perceived behavioural control) and the additional volitional variable of planning in relation to eating foods low in saturated fats. Self-report consumption of foods low insaturated fats was assessed 1 month later. In partial support of the theory of planned behaviour, results indicated that attitude and subjective norm predicted intentions to eat foods low in saturated fats and intentions and perceived behavioural control predicted the consumption of foods low in saturated fats. As an additional variable, planning predicted the consumption of foods low in saturated fats directly and also mediated the intention–behaviour and perceived behavioural control–behaviour relationships, suggesting an important role for planning as a post-intentional construct determining healthy eating choices. Suggestions are offered for interventions designed to improve adherence to healthy eating recommendations for people diagnosed with these chronic conditions with a specific emphasis on the steps and activities that are required to promote a healthier lifestyle.

Randomised controlled trial of an automated, interactive telephone intervention to improve type 2 diabetes self-management (Telephone-Linked Care Diabetes Project) : study protocol

Background: An estimated 285 million people worldwide have diabetes and its prevalence is predicted to increase to 439 million by 2030. For the year 2010, it is estimated that 3.96 million excess deaths in the age group 20-79 years are attributable to diabetes around the world. Self-management is recognised as an integral part of diabetes care. This paper describes the protocol of a randomised controlled trial of an automated interactive telephone system aiming to improve the uptake and maintenance of essential diabetes self-management behaviours. ---------- Methods/Design: A total of 340 individuals with type 2 diabetes will be randomised, either to the routine care arm, or to the intervention arm in which participants receive the Telephone-Linked Care (TLC) Diabetes program in addition to their routine care. The intervention requires the participants to telephone the TLC Diabetes phone system weekly for 6 months. They receive the study handbook and a glucose meter linked to a data uploading device. The TLC system consists of a computer with software designed to provide monitoring, tailored feedback and education on key aspects of diabetes self-management, based on answers voiced or entered during the current or previous conversations. Data collection is conducted at baseline (Time 1), 6-month follow-up (Time 2), and 12-month follow-up (Time 3). The primary outcomes are glycaemic control (HbA1c) and quality of life (Short Form-36 Health Survey version 2). Secondary outcomes include anthropometric measures, blood pressure, blood lipid profile, psychosocial measures as well as measures of diet, physical activity, blood glucose monitoring, foot care and medication taking. Information on utilisation of healthcare services including hospital admissions, medication use and costs is collected. An economic evaluation is also planned.---------- Discussion: Outcomes will provide evidence concerning the efficacy of a telephone-linked care intervention for self-management of diabetes. Furthermore, the study will provide insight into the potential for more widespread uptake of automated telehealth interventions, globally.

Intake of isoflavone and lignan phytoestrogens and associated demographic and lifestyle factors in older Australian women

The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investigate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women’s Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related differences in lignan intake. Forty-five percent of women consumed at least one serve of a soy and/or linseed item and were defined as a soy/linseed consumer. Median (range) intakes by consumers for isoflavones and lignans (3.9 (0-172) mg/d and 2.4 (0.1-33) mg/d) were higher than intakes by non-consumers (0.004 (0-2.6) mg/d and 1.57 (0.44-4.7) mg/d), respectively (p<0.001). Consumers had higher intakes of dietary fibre (p=0.003), energy (p=0.04) and polyunsaturated fat (p=0.004), and higher levels of physical activity (p=0.006), socio-economic position (p<0.001), education (p<0.001) and supplement use (p<0.001). Women who consumed soy or linseed foods differed in lifestyle and demographic characteristics suggesting these factors should be considered when investigating associations with chronic disease outcomes.

Preface : sustainable urban and regional infrastructure development : technologies, applications and management

The concept of ‘sustainability’ has been pushed to the forefront of policy-making and politics as the world wakes up to the impacts of climate change and the effects of the modern urban lifestyle. Climate change has emerged to be one of the biggest challenges faced by our planet today, threatening both built and natural systems with long term consequences which may be irreversible. While there is a vast literature in the market on sustainable cities and urban development, there is currently none that bring together the vital issues of urban and regional development, and the planning, management and implementation of sustainable infrastructure. Large scale infrastructure plays an important part in modern society by not only promoting economic growth, but also by acting as a key indicator for it. More importantly, it supplies municipal/local amenity and services: water, electricity, social and communication facilities, waste removal, transport of people and goods, as well as numerous other services. For the most part, infrastructure has been built by teams lead by engineers who are more concerned about functionality than the concept of sustainability. However, it has been widely stated that current practices and lifestyle cannot continue if we are to leave a healthy living planet to not only the next generation, but also to the generations beyond. Therefore, in order to be sustainable, there are drastic measures that need to be taken. Current single purpose and design infrastructures that are open looped are not sustainable; they are too resource intensive, consume too much energy and support the consumption of natural resources at a rate that will exhaust their supply. Because of this, it is vital that modern society, policy-makers, developers, engineers and planners become pioneers in introducing and incorporating sustainable features into urban and regional infrastructure.

Age and gender differences in ambulance utilisation in Queensland

Introduction Queensland has the highest ambulance utilisation (150 per 1000 population) in Australia and growing 4.4% annually. However, the impact of gender and age on utilisation is unknown. Methods & Materials Data on ambulance utilisation from Queensland Ambulance Service for the period 2002-2009 were analysed. Results Between 2002 and 2009, the number of ambulance patients per 1000 population increased overall by 17% (females) and 18% (males). The utilisation rate remained highest among the elderly but grew differently across age groups. For females, the rates were 55% (0-14yo), 73% (15-29yo), 38% (30-44yo), 22% (45-59yo), -9% (60-74yo) and -6% (75,+ yo); for males they were 48%, 59%, 38%, 17%, -13% and -2% respectively. Within the same age groups and period, the population adjusted number of males per 100 females (M:F ratio) changed from 134 to 128 (-5% growth), 98 to 91 (-8%), 101 to 100 (-0.4%), 115 to 111 (-3%), 114 to 108 (-5%) and 106 to 111 (4%). Conclusion Understanding the impact of patients’ demographic profiles on service utilisation and broader effects on the emergency health system is imperative for policy-making, demand management, designing public health campaigns and health promotions. Gender and age characteristics of ambulance users in Queensland appear to be changing most noticeably in the youngest and oldest groups. Physical and mental health, attitudinal, lifestyle, parenting, financial and socio-cultural reasons may account for these trends, but little evidence exists. A theoretical framework will be discussed to contextualise the findings.