An economic approach towards estimating health impacts of major transport investments and transport policies: A case study of transport emission abatement policy

The PhD thesis developed an economic model as an integral part of the current Health Impact Assessment (HIA) framework. Based on a Health Production Function approach, the model showed how to estimate economic benefits of positive health gains generated by transport investment programs and transport policies. Using Australian mortality and morbidity statistics and applying econometric analysis, the case study quantified health benefits induced by transport emission abatement policies in dollar terms for the Australian households. Finally, the thesis demonstrated transferability of the economic model through two example case studies, establishing a wider application capacity of the model.

Cultural safety and diversity: Refocusing our energies in mental health nursing practice, education and research

INTRODUCTION AND BACKGROUND: This presentation draws on a body of work assessing cultural safety's potential to generate change in mental health nursing research (Cox and Simpson 2015), in education and in clinical practice (Cox and Taua 2013, 2016; Happell, Cowin, Roper, Lakeman & Cox 2013). It presents evidence to suggest that cultural safety could resolve the conceptual confusion surrounding culture and diversity in nursing curricular, in clinical and in research practice. The history and nature of mental health work recommend cultural safety to focus attention on diversity, power imbalance, racism, cultural dominance, and structural inequality, identified as barriers and tensions in clinical practice and in service user participation. Cultural safety gives mental health nursing a well theorized and articulated model, which is evolving to improve practice into the future. DESCRIPTION: This work involved an immersion in the literature on cultural safety and the Service User Research movement. It draws on 5 months' work with a service users' research group in the UK and reflections on 9 years of cultural safety teaching. POLICY/PRACTICE CHANGE: This work provokes a crucial change of emphasis from locating the source of issues in the diversity of people to locating it in how society responds to diversity: a change from individualistic to systemic concerns. IMPLICATIONS FOR MENTAL HEALTH NURSING: Cultural safety in clinical practice, education, and research is specifically concerned with awareness of the impact of systemic workplace cultures and with staff cultural self-awareness to bring about cultural change and person-centred care of individuals' unique needs and aspirations within their life context.

The Trans-Pacific Partnership Poses a Grave Threat to Sustainable Development

This month’s long-awaited release of the Trans-Pacific Partnership (TPP) text was the result of years of negotiations on trade ties between nations around the Pacific Rim. Some six weeks earlier, another set of deliberations came to an end as the United Nations unveiled its 17 Sustainable Development Goals (SDGs), which aim to eradicate poverty and reduce inequality by addressing critical issues such as food security, health care, access to education, clean and affordable water, clean energy, and climate action. Unfortunately, the two documents are incompatible. Several chapters of the TPP impinge upon the SDGs, potentially undermining the UN’s efforts to promote sustainable development and equality throughout the Pacific region. Moreover, many developing countries, least-developed countries, and small island states in the Pacific region are excluded from the preferential trade deal.

Editorial: Closing the gap: Nurses and midwives making a difference

Life expectancy at birth is one of the main indicators of health inequality. Current health and social status indicators for Australian Indigenous people demonstrate major discrepancies in comparison to other Australians. For example, in Australia in 2005–2007 the Indigenous life expectancy gap at birth was 11.5 years for males and 9.7 years for females (Australian Bureau of Statistics, 2009). This gap has remained relatively constant over the last few decades (ABS, 2008). While the main causes of death for Indigenous Australians are similar to those of non-Indigenous Australians, the percentages attributed to the different disease categories are significantly different. For example, death from external causes is 16.2% for the Indigenous population compared to 6.3% for non-Indigenous, and diabetes is 8% for Indigenous Australians compared to 2.4% for non-Indigenous (ABS, 2008; AIHW, 2008). The Australian Government’s response to this troubling issue, urged on by unprecedented support from the public, was the Close the Gap initiative which aims to reduce the gap in life expectancy within a generation (Shadow Report, 2010). Since the introduction of the Close the Gap strategy there have been some claims of success. For example, the Honourable Warren Snowden (Snowden, 2010), Minister for Indigenous Health, outlines some of the changes that have occurred as a result of the implementation of the Indigenous Chronic Disease Package, funded at $805.5 million over four years, as: 294 new positions...

Reducing tariffs according to WTO accession rules: The case of Vietnam

When Vietnam joined the World Trade Organization (WTO) in 2007 it was granted an accession period up to 2014. During this period tariffs would have to fall according to the accession agreement. This paper evaluates this 2007–2014 trade liberalization by building an applied general equilibrium model and calibrating it to the Vietnamese data. The model pays careful attention to the fact that Vietnam has many state-owned enterprises. The model simulations show that the WTO tariff reductions will reduce overall welfare. Moreover, the biggest loss will take place among the poor rural households in Vietnam. This paper proposes other tariff reforms that will both raise overall welfare and reduce income inequality.

Kafka on the Shore

Kafka On The Shore consists of three simple concrete letterforms floating on a gallery wall. Reminiscent of minimalist sculpture, the mathematical expression of the letterforms states that ‘r’ is greater than ‘g’. Despite this material simplicity, the solemn presentation of the formula suggests a sense of foreboding, a quiet menace. The work was created as a response to the economic theories of Thomas Piketty presented in his book Capital in the Twenty-First Century. The primary finding of Piketty’s data-driven research is the formula presented by the work; that historically, wealth and inequity both flourish when the rate of return on capital (r) is greater than the rate of economic growth (g). With this simple mathematical summary the book acts as a sobering indictment on the present state of economic inequality.

Innovative telemedicine and mobile phone technology in the management of diabetic foot ulcers

Background Diabetic foot ulcers (DFU) are a leading cause of diabetes-related hospitalisation and can be costly to manage without access to appropriate expert care. Within Queensland and indeed across many parts of Australia, there is an inequality in accessing specialist services for individuals with DFU. Recent National Health and Medical Research Council (NHMRC) diabetic foot guidelines recommend remote expert consultation with digital imaging should be made available to people with DFU to improve their clinical outcomes. Telemedicine appears to show promise in improving access to diabetic foot specialist services; however diabetic foot telemedicine models to date have relied upon videoconferencing, store and forward technology and/or customised appliances to obtain digital imagery which all require either expensive infrastructure or a timed reply to the request for advice. Whilst mobile phone advice services have been used with success in general diabetes management and telehealth services have improved diabetic foot outcomes, the rapid emergence in the use of mobile phones has established a need to review the role that various forms of telemedicine play in the management of DFU. The aim of this paper is to review traditional telemedicine modalities that have been used in the management of DFU and to compare that to new and innovative technology that are emerging. Process Studies investigating the management of DFU using various forms of telemedicine interventions will be included in this review. They include the use of videoconferencing technology, hand held digital still photography purpose built imaging devices and mobile phone imagery. Electronic databases (Pubmed, Medline and CINAHL) will be searched using broad MeSH terms and keywords that cover the intended area of interest. Findings It is anticipated that the results of this narrative review will provide delegates of the 2015 Australasian Podiatry Conference an insight into the types of emerging innovative diagnostic telemedicine technologies in the management of DFU against the backdrop of traditional and evidence based modalities. It is anticipated that the findings will drive further research in the area of mobile phone imagery and innovation in the management of DFU.

Grand challenges for public health

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