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.

Gifted young adolescents and email : developing a personal language of self

This paper reports on the use of email as a means to access the self-constructions of gifted young adolescents. Australian research shows that gifted young adolescents may feel more lonely and misunderstood than their same-age counterparts, yet they are seldom asked about their lives. Emerging use of online methods as a means of access to individual lives and perceptions has demonstrated the potential offered by the creation of digital texts as narrative data. Details are given of a qualitative study that engaged twelve children aged between 10 and 14 years, who were screened for giftedness, in a project involving the generation of emailed journal entries sent over a period of 6 months. With emphasis on participatory principles, individual young adolescents produced self-managed journal entries that were written and sent to the researcher from personal computers outside the school setting. Drawing from a theoretical understanding of self as constructed within dialogic relationships, the digital setting of email is proposed as a narrative space that fosters healthy self-disclosure. This paper outlines the benefits of using email as a means to explore emotions, promote reflective accounts of self and support the development of a personal language for self-expression. Individual excerpts will be presented to show that the harnessing of personal narratives within an email context has potential to yield valuable insights into the emotions, personal realities and experiences of gifted young adolescents. Findings will be presented to show that the co-construction of self-expressive and explanatory narratives supported by a facilitative adult listener promoted healthy self-awareness amongst participants. This paper contributes to appreciative conversations about using online methods as a flexible and practical avenue for conducting educational research. Furthermore, digital writing in email form will be presented as having distinct advantages over face-to-face methods when utilised with gifted young adolescents who may be unwilling to disclose information within school-based settings.

Epidemiology

The aim of this chapter is to provide you with a basic understanding of epidemiology, and to introduce you to some of the epidemiological concepts and methods used by researchers and practitioners working in public health. It is hoped that you will recognise how the principles and practice of epidemiology help to provide information and insights that can be used to achieve better health outcomes for all. Epidemiology is fundamental to preventive medicine and public health policy. Rather than examine health and illness on an individual level, as clinicians do, epidemiologists focus on communities and population health issues. The word epidemiology is derived from the Greek epi (on, upon), demos (the people) and logos (the study of). Epidemiology, then, is the study of that which falls upon the people. Its aims are to describe health-related states or events, and through systematic examination of the available information, attempt to determine their causes. The ultimate goal is to contribute to prevention of disease and disability and to delay mortality. The primary question of epidemiology is: why do certain diseases affect particular population groups? Drawing upon statistics, the social and behavioural sciences, the biological sciences and medicine, epidemiologists collect and interpret information to assist in the prevention of new cases of disease, eradicate existing disease and prolong the lives of people who have disease.

In Bed with Autobiography: Unravelling the Fabric of Gender and Genre in Women’s Bed(room) Confessions

This thesis consists of a confessional narrative, What My Mother Doesn’t Know, and an accompanying exegesis, And Why I Should (Maybe) Tell Her. The creative piece employs the confessional mode as a subversive device in three separate narratives, each of which situates the bed as a site of resistance. The exegesis investigates how this self-disclosure in a domestic space flouts the governing rules of self-representation, specifically: telling the truth, respecting privacy and displaying normalcy. The female confession, I argue, creates an alternative space in women’s autobiography where notions of truth-telling can be undermined, the political dimensions of personal experience can be uncovered and the discourse of normality can be negotiated. In particular, women’s confessions told in, on or about the bed, dismantle the genre’s illusion of self and confirm the representative aspects of women’s experience. Framed within these parameters of power and powerlessness, the exegesis includes textual analyses of Charlotte Perkins Gilman’s The Yellow Wallpaper (1892), Tracey Emin’s My Bed (1999) and Lauren Slater’s Lying (2000), each of which exposes in a bedroom space, the author’s most obscure, intimate and traumatic experiences. Situated firmly within and against the genre’s traditional masculine domain, the exegesis also includes mediations on the creative work that validate the bed as my fabric for confession.

Traveller’s Tales : ELT teachers in a globalising world

This chapter summarizes a quasi-ethnographic case study of the lives and work of nine native-speaking English language teachers who have lived and worked outside their countries of origin for extended periods. The study aimed to document the complexity of ELT as ‘work’ in new global economic and cultural conditions, and to explore how this complexity is realised in the everyday experiences of ELT teachers.

Structural behaviour and design of cold-formed steel beams at elevated temperatures

Cold-formed steel members are extensively used in the building construction industry, especially in residential, commercial and industrial buildings. In recent times, fire safety has become important in structural design due to increased fire damage to properties and loss of lives. However, past research into the fire performance of cold-formed steel members has been limited, and was confined to compression members. Therefore a research project was undertaken to investigate the structural behaviour of compact cold-formed steel lipped channel beams subject to inelastic local buckling and yielding, and lateral-torsional buckling effects under simulated fire conditions and associated section and member moment capacities. In the first phase of this research, an experimental study based on tensile coupon tests was undertaken to obtain the mechanical properties of elastic modulus and yield strength and the stress-strain relationship of cold-formed steels at uniform ambient and elevated temperatures up to 700oC. The mechanical properties deteriorated with increasing temperature and are likely to reduce the strength of cold-formed beams under fire conditions. Predictive equations were developed for yield strength and elastic modulus reduction factors while a modification was proposed for the stressstrain model at elevated temperatures. These results were used in the numerical modelling phases investigating the section and member moment capacities. The second phase of this research involved the development and validation of two finite element models to simulate the behaviour of compact cold-formed steel lipped channel beams subject to local buckling and yielding, and lateral-torsional buckling effects. Both models were first validated for elastic buckling. Lateral-torsional buckling tests of compact lipped channel beams were conducted at ambient temperature in order to validate the finite element model in predicting the non-linear ultimate strength behaviour. The results from this experimental study did not agree well with those from the developed experimental finite element model due to some unavoidable problems with testing. However, it highlighted the importance of magnitude and direction of initial geometric imperfection as well as the failure direction, and thus led to further enhancement of the finite element model. The finite element model for lateral-torsional buckling was then validated using the available experimental and numerical ultimate moment capacity results from past research. The third phase based on the validated finite element models included detailed parametric studies of section and member moment capacities of compact lipped channel beams at ambient temperature, and provided the basis for similar studies at elevated temperatures. The results showed the existence of inelastic reserve capacity for compact cold-formed steel beams at ambient temperature. However, full plastic capacity was not achieved by the mono-symmetric cold-formed steel beams. Suitable recommendations were made in relation to the accuracy and suitability of current design rules for section moment capacity. Comparison of member capacity results from finite element analyses with current design rules showed that they do not give accurate predictions of lateral-torsional buckling capacities at ambient temperature and hence new design rules were developed. The fourth phase of this research investigated the section and member moment capacities of compact lipped channel beams at uniform elevated temperatures based on detailed parametric studies using the validated finite element models. The results showed the existence of inelastic reserve capacity at elevated temperatures. Suitable recommendations were made in relation to the accuracy and suitability of current design rules for section moment capacity in fire design codes, ambient temperature design codes as well as those proposed by other researchers. The results showed that lateral-torsional buckling capacities are dependent on the ratio of yield strength and elasticity modulus reduction factors and the level of non-linearity in the stress-strain curves at elevated temperatures in addition to the temperature. Current design rules do not include the effects of non-linear stress-strain relationship and therefore their predictions were found to be inaccurate. Therefore a new design rule that uses a nonlinearity factor, which is defined as the ratio of the limit of proportionality to the yield stress at a given temperature, was developed for cold-formed steel beams subject to lateral-torsional buckling at elevated temperatures. This thesis presents the details and results of the experimental and numerical studies conducted in this research including a comparison of results with predictions using available design rules. It also presents the recommendations made regarding the accuracy of current design rules as well as the new developed design rules for coldformed steel beams both at ambient and elevated temperatures.

Towards developing an integrated model of information behaviour

This paper presents the results from a study of information behaviors in the context of people's everyday lives undertaken in order to develop an integrated model of information behavior (IB). 34 participants from across 6 countries maintained a daily information journal or diary – mainly through a secure web log – for two weeks, to an aggregate of 468 participant days over five months. The text-rich diary data was analyzed using a multi-method qualitative-quantitative analysis in the following order: Grounded Theory analysis with manual coding, automated concept analysis using thesaurus-based visualization, and finally a statistical analysis of the coding data. The findings indicate that people engage in several information behaviors simultaneously throughout their everyday lives (including home and work life) and that sense-making is entangled in all aspects of them. Participants engaged in many of the information behaviors in a parallel, distributed, and concurrent fashion: many information behaviors for one information problem, one information behavior across many information problems, and many information behaviors concurrently across many information problems. Findings indicate also that information avoidance – both active and passive avoidance – is a common phenomenon and that information organizing behaviors or the lack thereof caused the most problems for participants. An integrated model of information behaviors is presented based on the findings.

Spatial information infrastructure : what can it possibly mean?

Investment begins with imagining that doing something new in the present will lead to a better future. Investment can vary from incidental improvements as safe and beneficial side-effects of current activity through to a more dedicated and riskier disinvestment in current methods of operation and reinvestment in new processes and products. The role of government has an underlying continuity determined by its constitution that authorises a parliament to legislate for peace, order and good government. ‘Good government’ is usually interpreted as improving the living standards of its citizens. The requirements for social order and social cohesion suggest that improvements should be shared fairly by all citizens through all of their lives. Arguably, the need to maintain an individual’s metabolism has a social counterpart in the ‘collective metabolism’ of a sustainable and productive society.

Narratives for novices : is there a place for edgy texts in edgy NAPLAN communities?

The genre of narratives has become the genre of choice in many classrooms since the introduction of NAPLAN into Australian schools. Yet, Knapp and Watkins (2005) argue that narratives are the least understood of all the genres. Despite wide-spread acceptance that narratives serve the social purpose of entertaining, they can also be more edgy, offering a powerful social or information role. This paper considers the effects of exposing novices to less standard realms of social discourse and disciplinary knowledge vis-a-vis a more clinical treatment focused on ‘standard’ narratives. I argue that we should not shy away from the challenges of edgy narratives just because our students are novice readers. The same holds true for our work in communities on the edge, that is where poverty, multiculturalism or multilingualism and systemic failure are the norm. I am part of an Australian Research Council (ARC) Linkage Grant (LP 0990289) working in such a community. Like many such situations, teachers in these communities are caught in the fray of establishing a dialogue between the culture of federally mandated performance orientated reforms and the cultures and discourses of the lives and future needs of their students (see Exley & Singh, in press).

Advice-implicative interrogatives : building 'client-centered" support in a children's helpline

Interactional research on advice giving has described advice as normative and asymmetric. In this paper we examine how these dimensions of advice are softened by counselors on a helpline for children and young people through the use of questions. Through what we term ‘‘adviceimplicative interrogatives,’’ counselors ask clients about the relevance or applicability of a possible future course of action. The allusion to this possible action by the counselor identifies it as normatively relevant, and displays the counselor’s epistemic authority in relation to dealing with a client’s problems. However, the interrogative format mitigates the normative and asymmetric dimensions typical of advice sequences by orienting to the client’s epistemic authority in relation to their own lives, and delivering advice in a way that is contingent upon the client’s accounts of their experiences, capacities, and understandings. The demonstration of the use of questions in advice sequences offers an interactional specification of the ‘‘client-centered’’ support that is characteristic of prevailing counseling practice. More specifically, it shows how the values of empowerment and child-centered practice, which underpin services such as Kids Helpline, are embodied in specific interactional devices. Detailed descriptions of this interactional practice offer fresh insights into the use of interrogatives in counseling contexts, and provide practitioners with new ways of thinking about, and discussing, their current practices.

Designing ePortfolios for music postgraduate study : a practice-led inquiry

In this research I have examined how ePortfolios can be designed for Music postgraduate study through a practice led research enquiry. This process involved designing two Web 2.0 ePortfolio systems for a group of five post graduate music research students. The design process revolved around the application of an iterative methodology called Software Develop as Research (SoDaR) that seeks to simultaneously develop design and pedagogy. The approach to designing these ePortfolio systems applied four theoretical protocols to examine the use of digitised artefacts in ePortfolio systems to enable a dynamic and inclusive dialogue around representations of the students work. The research and design process involved an analysis of existing software and literature with a focus upon identifying the affordances of available Web 2.0 software and the applications of these ideas within 21st Century life. The five post graduate music students each posed different needs in relation to the management of digitised artefacts and the communication of their work amongst peers, supervisors and public display. An ePortfolio was developed for each of them that was flexible enough to address their needs within the university setting. However in this first SoDaR iteration data gathering phase I identified aspects of the university context that presented a negative case that impacted upon the design and usage of the ePortfolios and prevented uptake. Whilst the portfolio itself functioned effectively, the university policies and technical requirements prevented serious use. The negative case analysis of the case study found revealed that Access and Control and Implementation, Technical and Policy Constraints protocols where limiting user uptake. From the semistructured interviews carried out as part of this study participant feedback revealed that whilst the participants did not use the ePortfolio system I designed, each student was employing Web 2.0 social networking and storage processes in their lives and research. In the subsequent iterations I then designed a more ‘ideal’ system that could be applied outside of the University context that draws upon the employment of these resources. In conclusion I suggest recommendations about ePortfolio design that considers what the applications of the theoretical protocols reveal about creative arts settings. The transferability of these recommendations are of course dependent upon the reapplication of the theoretical protocols in a new context. To address the mobility of ePortfolio design between Institutions and wider settings I have also designed a prototype for a business card sized USB portal for the artists’ ePortfolio. This research project is not a static one; it stands as an evolving design for a Web 2.0 ePortfolio that seeks to refer to users needs, institutional and professional contexts and the development of software that can be incorporated within the design. What it potentially provides to creative artist is an opportunity to have a dialogue about art with artefacts of the artist products and processes in that discussion.

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.

Safety impacts of alcohol and other drugs in construction : a mid term report

Estimated 640,700 persons suffered a work-related injury or illness in 2009-2010 and 444 lost their lives as a result in 2008-2009, in Australia Very little is known about what proportion of accidents are directly attributable to the effects of AOD Anecdotal evidence highlights issues of AOD and its association with safety risk on construction sites

Developing a model of care to improve the health and well-being for Indigenous people receiving renal dialysis treatment

The high levels of end-stage renal disease among Indigenous Australians, particularly in remote areas of the country, are a serious public health concern. The magnitude of the problem is reflected in figures from the Australian and New Zealand Transplant and Dialysis Registry that show that Indigenous Australians experience end-stage renal disease at a rate almost 9–10 times higher than other non-Indigenous Australians. A majority of Indigenous Australians have to relocate to receive appropriate renal dialysis treatment. In some Australian states, renal treatment is based on self-care dialysis which allows those Indigenous Australians to be treated back in their community. Evidence clearly shows that reuniting renal patients with community and family improves overall health and well-being for those Indigenous Australians. With the appropriate resources, training, and support, self-care management of renal dialysis treatment is an effective way for Indigenous people with end-stage renal failure to be treated at home. In this context, the study was used to gain insight and further understanding of the impact that end-stage renal disease and renal dialysis treatment has had on the lives of Indigenous community members. The study findings are from 14 individually interviewed people from South East Queensland. Data from the interviews were analysed using a combination of thematic and content analysis. The study methodology was based on qualitative data principles where the Indigenous community members were able to share their experiences and journeys living with end-stage renal disease. Many of the experiences and understanding closely relate to the renal disease pattern and the treatment with other outside influences, such as social, cultural, and environmental influences, all having an equal impact. Each community member’s experience with end-stage renal disease is unique; some manage with family and medical support, while others try to manage independently. From the study, community members who managed their renal dialysis treatment independently were much more aware of their renal health status. The study provides recommendations towards a model of care to improve the health and well-being is based on self-care and self-determination principles.

Multi-linear strategies for (re)presenting the complexity of young people in research

Within the current climate of unpredictability and constant change, young people at school are faced with a multitude of choices and contradictory influences. In this article, I argue that (re)presentations of young people in youth research need to reflect the complexity and multiplicity of their lives and changing priorities, and I attempt to (re)present a small group of young people in this particular milieu. I illustrate some of the competing influences in their lives, and I outline some specific strategies that are useful for (re)presenting these contextual worlds. The strategies I advocate disrupt the homogenous representations of ‘youth’ as a developmental phase and instead reflect the diverse spheres of influence which shape their subjectivities and practices.