My place through my eyes : a social constructionist approach to researching the relationships between socioeconomic living contexts and physical activity

There is a growing evidence-base in the epidemiological literature that demonstrates significant associations between people’s living circumstances – including their place of residence – and their health-related practices and outcomes (Leslie, 2005; Karpati, Bassett, & McCord, 2006; Monden, Van Lenthe, & Mackenbach, 2006; Parkes & Kearns, 2006; Cummins, Curtis, Diez-Roux, & Macintyre, 2007; Turrell, Kavanagh, Draper, & Subramanian, 2007). However, these findings raise questions about the ways in which living places, such as households and neighbourhoods, figure in the pathways connecting people and health (Frolich, Potvin, Chabot, & Corin, 2002; Giles-Corti, 2006; Brown et al, 2006; Diez Roux, 2007). This thesis addressed these questions via a mixed methods investigation of the patterns and processes connecting people, place, and their propensity to be physically active. Specifically, the research in this thesis examines a group of lower-socioeconomic residents who had recently relocated from poorer suburbs to a new urban village with a range of health-related resources. Importantly, the study contrasts their historical relationship with physical activity with their reactions to, and everyday practices in, a new urban setting designed to encourage pedestrian mobility and autonomy. The study applies a phenomenological approach to understanding living contexts based on Berger and Luckman’s (1966) conceptual framework in The Social Construction of Reality. This framework enables a questioning of the concept of context itself, and a treatment of it beyond environmental factors to the processes via which experiences and interactions are made meaningful. This approach makes reference to people’s histories, habituations, and dispositions in an exploration between social contexts and human behaviour. This framework for thinking about context is used to generate an empirical focus on the ways in which this residential group interacts with various living contexts over time to create a particular construction of physical activity in their lives. A methodological approach suited to this thinking was found in Charmaz’s (1996; 2001; 2006) adoption of a social constructionist approach to grounded theory. This approach enabled a focus on people’s own constructions and versions of their experiences through a rigorous inductive method, which provided a systematic strategy for identifying patterns in the data. The findings of the study point to factors such as ‘childhood abuse and neglect’, ‘early homelessness’, ‘fear and mistrust’, ‘staying indoors and keeping to yourself’, ‘conflict and violence’, and ‘feeling fat and ugly’ as contributors to an ongoing core category of ‘identity management’, which mediates the relationship between participants’ living contexts and their physical activity levels. It identifies barriers at the individual, neighbourhood, and broader ecological levels that prevent this residential group from being more physically active, and which contribute to the ways in which they think about, or conceptualise, this health-related behaviour in relationship to their identity and sense of place – both geographic and societal. The challenges of living well and staying active in poorer neighbourhoods and in places where poverty is concentrated were highlighted in detail by participants. Participants’ reactions to the new urban neighbourhood, and the depth of their engagement with the resources present, are revealed in the context of their previous life-experiences with both living places and physical activity. Moreover, an understanding of context as participants’ psychological constructions of various social and living situations based on prior experience, attitudes, and beliefs was formulated with implications for how the relationship between socioeconomic contextual effects on health are studied in the future. More detailed findings are presented in three published papers with implications for health promotion, urban design, and health inequalities research. This thesis makes a substantive, conceptual, and methodological contribution to future research efforts interested in how physical activity is conceptualised and constructed within lower socioeconomic living contexts, and why this is. The data that was collected and analysed for this PhD generates knowledge about the psychosocial processes and mechanisms behind the patterns observed in epidemiological research regarding socioeconomic health inequalities. Further, it highlights the ways in which lower socioeconomic living contexts tend to shape dispositions, attitudes, and lifestyles, ultimately resulting in worse health and life chances for those who occupy them.

Prags Boulevard in Copenhagen : from run-down strip to boulevard

Prags Boulevard will form a 2km long pedestrian spine running east-west between the historic cities of Copenhagen and Amager. It is located on a some-what run down site, which accommodated illicit functions such as casual drug use and drinking, as well as sheds for squatters. The renovation of this site by the city of Copenhagen forms part of the Holmbladsgade renovation project, and a two-phase competition was held in 2001 to develop a green area and meeting place, transforming it into a place that residents would want to visit rather than avoid. The designer, local landscape architect Kristine Jensens recognises that though the site is linear it ‘has no traffic importance’, though as she notes ‘we like the project because it runs straight east west from the city pulse to the water of Oresund’. In developing the project, she has attempted to allow it to ‘run parallel’ to its existing illicit uses, using a ‘light touch’ of insertions. While it would be hard to describe the project as truly light in its touch (graphically, it is a very bold scheme), there is no doubt that it is parallel: in terms of use it runs alongside rather than against existing uses; in terms of its type it’s all about length, like a boulevard, although it clearly differs from a boulevard in other respects.

All-terrain vehicle crashes and associated injuries in North Queensland : findings from the Rural and Remote Road Safety Study

Objective: To define characteristics of all-terrain vehicle (ATV) crashes occurring in north Queensland from March 2004 till June 2007 with the exploration of associated risk factors. Design: Descriptive analysis of ATV crash data collected by the Rural and Remote Road Safety Study. Setting: Rural and remote north Queensland. Participants: Forty-two ATV drivers and passengers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. Main outcome measures: Demographics of participants, reason for travel, nature of crash, injuries sustained and risk factors associated with ATV crash. Results: The majority of casualties were men aged 16–64. Forty-one per cent of accidents occurred while performing agricultural tasks. Furthermore, 39% of casualties had less than one year’s experience riding ATVs. Over half the casualties were not wearing a helmet at the time of the crash. Common injuries were head and neck and upper limb injuries. Rollovers tended to occur while performing agricultural tasks and most commonly resulted in multiple injuries. Conclusions: Considerable trauma results from ATV crashes in rural and remote north Queensland. These crashes are not included in most general vehicle crash data sets, as they are usually limited to events occurring on public roads. Minimal legislation and regulation currently applies to ATV use in agricultural, recreational and commercial settings. Legislation on safer design of ATVs and mandatory courses for riders is an essential part of addressing the burden of ATV crashes on rural and remote communities.

Crowd Counting Using Multiple Local Features

In public venues, crowd size is a key indicator of crowd safety and stability. Crowding levels can be detected using holistic image features, however this requires a large amount of training data to capture the wide variations in crowd distribution. If a crowd counting algorithm is to be deployed across a large number of cameras, such a large and burdensome training requirement is far from ideal. In this paper we propose an approach that uses local features to count the number of people in each foreground blob segment, so that the total crowd estimate is the sum of the group sizes. This results in an approach that is scalable to crowd volumes not seen in the training data, and can be trained on a very small data set. As a local approach is used, the proposed algorithm can easily be used to estimate crowd density throughout different regions of the scene and be used in a multi-camera environment. A unique localised approach to ground truth annotation reduces the required training data is also presented, as a localised approach to crowd counting has different training requirements to a holistic one. Testing on a large pedestrian database compares the proposed technique to existing holistic techniques and demonstrates improved accuracy, and superior performance when test conditions are unseen in the training set, or a minimal training set is used.

Long-term outcomes of seriously injured children : a study using the Child Health Questionnaire

Objective: To assess the health-related quality of life (HRQoL) in children 1-2 years after they had sustained an injury. Methods: Parents of all children who were identified by the Queensland Trauma Registry during their admission to either of the two paediatric specialty hospitals in Brisbane, Australia, for the treatment of an injury, were invited to participate in this study. Parents who consented to participation received a copy of the Child Health Questionnaire (CHQ) that required them to provide information regarding their child’s HRQoL following injury. The CHQ scores for the study respondents were compared with those of the Australian norms. This study was approved by the relevant ethics committees. Results: Two hundred and forty-one completed questionnaires were returned. The majority of cases were male (65%) and there was even representation across all age groups. The majority of injuries were considered to be minor (81%) and were predominantly the result of falls and cycling accidents causing mainly fractures and intracranial injury. On the majority of subscales of the CHQ, study participants recorded scores that were statistically significantly below those of the Australian norms. None of the relevant variables collected by the Queensland Trauma Registry were found to predict scores on the CHQ in this study (for those children hospitalized for >24 h). Conclusion: Injured children are worse off than their Australian counterparts in terms of HRQoL even up to 2 years following an injury. Further research needs to be undertaken to identify factors that predict lower HRQoL in order to reduce the burden of injury on children and their families.

The effect of road lane width on cyclist safety in urban areas

Research has shown that road lane width impacts on driver behaviour. This literature review provides guidelines to assist in the design, construction and retrofitting of urban roads to accommodate road users' safety requirements. It focuses on the impacts of lane widths on cyclists and motor vehicle safety behaviour. The literature review commenced with a search of library databases. Peer reviewed articles and road authority (local, state and national) reports were reviewed. The majority of studies investigating the effects of lane width on driver behaviour were simulator based, while research into cycling safety involved data collected from actual traffic environments. Results show that marked road lane width influences perceived task difficulty, risk perception and possibly speed choice. The positioning of cyclists in traffic lanes is influenced by the presence of on-road cycling facilities and the total roadway width. The lateral displacement between bicycle and vehicle is smallest when a bicycle facility is present. Lower, or reduced, vehicle speeds play a significant role in improving bicyclist and pedestrian safety. It is also shown that if road lane widths in urban areas were reduced, to a functional width that was less than the current guidelines of 3.5m, it could result in a safer road environment for all road users.

Members abroad - Australia : Lindy Osborne

When I arrived in Queensland's capital in 1996, Brisbane was commonly referred to as an 'overgrown country town'. This might have been an acceptable description in the 1990s, but it cannot be applied any longer. Brisbane, affectionaly referred to by the locals as Bris-Vegas, has now come of age. Following Sydney and Melbourne, Brisbane is the third most populous city in Australia with a population of approximately two million. Interestingly, the 2006 Census showed that 22 per cent of Brisbane's population was born overseas, the three main countries of birth being the UK, New Zealand and South Africa. Brisbane City is centred on its most dominant environmental element, the Brisbane River, which effectively carves Brisbane into two areas - the Northside and the Southside. The 2001 addition of Cox Rayner's Goodwill Pedestrian and Cycle Bridge signified Brisbane's acceptance and affectionate embrace of its River resulting in a long overdue linage between Brisbane's North and South. It connects the City's key precincts - the Northside CBD through Queensland University of Technology (QUT), across Brisbane River, to the recreational precinct of the Southside Southbank Parklands. The Southside cultural precinct of Southbank is the home to Queensland's Art Gallery, Performing Arts Complex, State Library and Museum -each of which were designed by Brisbane Stalwart Architect Robin Gibson, in the 1970s and '80s. The CBD component of the Brisbane River is flanked by a number of Institutional Facilities, including the campuses of QUT, Griffith University and the Southbank Education and Training Precinct (SETP), which combine to form a cross-river educational precinct. The past decade has born witness to a city which has keenly supported emerging architects in addition to the more entrenched stalwarts of the profession, resulting in a youthful, relaxed and unpretentious sub-tropical city. Viva Bris-Vegas!

Safeguarding Rural Australia: Data Report No. 3 - Unintentional Violence

This report focuses on our examination of extant data which have been sourced with respect to unintentional serious and violent injuries to males living in regional and remote Australia. Such injuries typically might be caused by, for example, transport accidents, occupational exposures and hazards, burns and so on. Thus unintentional violent incidents cause physical trauma the consequences of which can sometimes lead to chronic conditions including psychological harm or substance abuse. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in complementary reports in this series.

An analysis of cyclists crashes to identify ITS-based intervention

Cycling provides a number of health and environmental benefits. However, cyclists are more likely to suffer serious injury or be killed in traffic accidents than car drivers and the estimated cost of crashes in Australia is $1.25AU billion per year. Current interventions to reduce bicycle crashes include compulsory helmet use, media campaigns, and the provision of cycling lanes, as well as road user education and training. It is difficult to assess the effectiveness of current interventions as there is no accurate measure of cyclist exposure in South East Queensland (SEQ). This paper analyses cyclist crash characteristics in Queensland with the view to identifying appropriate Intelligent Transport Systems (ITS) based intervention to reduce cyclist injury and death. The inappropriateness of some ITS interventions to improve cyclist safety is highlighted and a set of ITS interventions are identified, based on Queensland crash data 2002-2006.

Wireless channel modelling for indoor populated environments : statistical characterization of narrowband channels at 2.45 Ghz and 5.2 Ghz

The recent development of indoor wireless local area network (WLAN) standards at 2.45 GHz and 5 GHz has led to increased interest in propagation studies at these frequency bands. Within the indoor environment, human body effects can strongly reduce the quality of wireless communication systems. Human body effects can cause temporal variations and shadowing due to pedestrian movement and antenna- body interaction with portable terminals. This book presents a statistical characterisation, based on measurements, of human body effects on indoor narrowband channels at 2.45 GHz and at 5.2 GHz. A novel cumulative distribution function (CDF) that models the 5 GHz narrowband channel in populated indoor environments is proposed. This novel CDF describes the received envelope in terms of pedestrian traffic. In addition, a novel channel model for the populated indoor environment is proposed for the Multiple-Input Multiple-Output (MIMO) narrowband channel in presence of pedestrians at 2.45 GHz. Results suggest that practical MIMO systems must be sufficiently adaptive if they are to benefit from the capacity enhancement caused by pedestrian movement.

Planning and evaluation

Introduction: The core business of public health is to protect and promote health in the population. Public health planning is the means to maximise these aspirations. Health professionals develop plans to address contemporary health priorities as the evidence about changing patterns of mortality and morbidity is presented. Officials are also alert to international trends in patterns of disease that have the potential to affect the health of Australians. Integrated planning and preparation is currently underway involving all emergency health services, hospitals and population health units to ensure Australia's quick and efficient response to any major infectious disease outbreak, such as avian influenza (bird flu). Public health planning for the preparations for the Sydney Olympics and Paralympic Games in 2000 took almost three years. ‘Its major components included increased surveillance of communicable disease; presentations to sentinel emergency departments; medical encounters at Olympic venues; cruise ship surveillance; environmental and food safety inspections; bioterrorism surveillance and global epidemic intelligence’ (Jorm et al 2003, 102). In other words, the public health plan was developed to ensure food safety, hospital capacity, safe crowd control, protection against infectious diseases, and an integrated emergency and disaster plan. We have national and state plans for vaccinating children against infectious diseases in childhood; plans to promote dental health for children in schools; and screening programs for cervical, breast and prostate cancer. An effective public health response to a change in the distribution of morbidity and mortality requires planning. All levels of government plan for the public’s health. Local governments (councils) ensure healthy local environments to protect the public’s health. They plan parks for recreation, construct traffic-calming devices near schools to prevent childhood accidents, build shade structures and walking paths, and even embed drafts/chess squares in tables for people to sit and play. Environmental Health officers ensure food safety in restaurants and measure water quality. These public health measures attempt to promote the quality of life of residents. Australian and state governments produce plans that protect and promote health through various policy and program initiatives and innovations. To be effective, program plans need to be evaluated. However, building an integrated evaluation plan into a program plan is often forgotten, as planning and evaluation are seen as two distinct entities. Consequently, it is virtually impossible to measure, with any confidence, the extent to which a program has achieved its goals and objectives. This chapter introduces you to the concepts of public health program planning and evaluation. Case studies and reflection questions are presented to illustrate key points. As various authors use different terminology to describe the same concepts/actions of planning and evaluation, the glossary at the back of this book will help you to clarify the terms used in this chapter.

The rediscovery of traditional urbanism at Melrose Arch

Contemporary urban form, particularly in the cities of South Africa, lacks distinction and quality. The majority of developments are conceived as private and dislocated initiatives, surveiled enclaves with gated access being the only conduit to the outside world. Any concern for a positive contribution to the matrix of public activity is seldom a consideration. The urban form responds to the perception that traffic systems are paramount to the successful flux of the city in satisfying the escalating demands of vehicular movement. In contrast many of the urban centres around the world, the great historical centres of Europe, Americas and the Sub-Continent are admired and considered the ultimate models in urban experience. The colonnades, bazaars and boulevards hosting an abundance of street activity are the characteristics of such centres and are symptomatic of a city growth based on pedestrian movement patterns, an urbanism supportative of human interaction and exchange, a form which has nurtured the existence of a public realm. Through the understanding of the principles of traditional urbanism we may learn that the modernist paradigm of a contemporary suburbia has resulted in disconnected and separate land uses with isolated districts where a reliance on the car is essential rather than optional.

Parental beliefs about supervising children when crossing roads and cycling

Pedestrian and cyclist injuries are significant public health issues together accounting for 11-30% of road deaths in highly motorised countries. Children are particularly at risk. In Australia in 2009 children 0-16 years comprised 11.4% of pedestrian deaths and 6.4% of cyclist deaths. Parental attitudes and level of supervision are important to children’s road safety. Results from a telephone survey with parents of children 5-9 years (N=147) are reported. Questions addressed beliefs about preventability of injury, appropriate ages for children to cross the road or cycle independently, and the frequency of holding 5-9 year old children’s hands while crossing the road. Results suggest that parents believe most injuries are preventable and that they personally can act to improve their own safety in the home, on the road, at work, as well as in or on the water. Most parents (68%) indicated children should be 10 years or older before crossing the road or cycling independently. Parents were more likely to report holding younger children’s hands (5-6 years) when crossing the road and less likely to do so for 7-9 year olds. There was a small effect of child gender, with parents more likely to hold boy’s hand than a girl’s.

Modelling of inflatable rescue boats (IRBs) in surf conditions to reduce injuries

The Inflatable Rescue Boat (IRB) is arguably the most effective rescue tool used by the Australian surf lifesavers. The exceptional features of high mobility and rapid response have enabled it to become an icon on Australia's popular beaches. However, the IRB's extensive use within an environment that is as rugged as it is spectacular, has led it to become a danger to those who risk their lives to save others. Epidemiological research revealed lower limb injuries to be predominant, particularly the right leg. The common types of injuries were fractures and dislocations, as well as muscle or ligament strains and tears. The concern expressed by Surf Life Saving Queensland (SLSQ) and Surf Life Saving Australia (SLSA) led to a biomechanical investigation into this unique and relatively unresearched field. The aim of the research was to identify the causes of injury and propose processes that may reduce the instances and severity of injury to surf lifesavers during IRB operation. Following a review of related research, a design analysis of the craft was undertaken as an introduction to the craft, its design and uses. The mechanical characteristics of the vessel were then evaluated and the accelerations applied to the crew in the IRB were established through field tests. The data were then combined and modelled in the 3-D mathematical modelling and simulation package, MADYMO. A tool was created to compare various scenarios of boat design and methods of operation to determine possible mechanisms to reduce injuries. The results of this study showed that under simulated wave loading the boats flex around a pivot point determined by the position of the hinge in the floorboard. It was also found that the accelerations experienced by the crew exhibited similar characteristics to road vehicle accidents. Staged simulations indicated the attributes of an optimum foam in terms of thickness and density. Likewise, modelling of the boat and crew produced simulations that predicted realistic crew response to tested variables. Unfortunately, the observed lack of adherence to the SLSA footstrap Standard has impeded successful epidemiological and modelling outcomes. If uniformity of boat setup can be assured then epidemiological studies will be able to highlight the influence of implementing changes to the boat design. In conclusion, the research provided a tool to successfully link the epidemiology and injury diagnosis to the mechanical engineering design through the use of biomechanics. This was a novel application of the mathematical modelling software MADYMO. Other craft can also be investigated in this manner to provide solutions to the problem identified and therefore reduce risk of injury for the operators.