Application of an appearance-based intervention to improve sun protection outcomes of outdoor workers in Queensland, Australia

Outdoor workers are exposed to high levels of ultraviolet radiation (UVR) and may thus be at greater risk to experience UVR-related health effects such as skin cancer, sun burn, and cataracts. A number of intervention trials (n=14) have aimed to improve outdoor workers’ work-related sun protection cognitions and behaviours. Only one study however has reported the use of UV-photography as part of a multi-component intervention. This study was performed in the USA and showed long-term (12 months) improvements in work-related sun protection behaviours. Intervention effects of the other studies have varied greatly, depending on the population studied, intervention applied, and measurement of effect. Previous studies have not assessed whether: - Interventions are similarly effective for workers in stringent and less stringent policy organisations; - Policy effect is translated into workers’ leisure time protection; - Implemented interventions are effective in the long-term; - The facial UV-photograph technique is effective in Australian male outdoor workers without a large additional intervention package, and; - Such interventions will also affect workers’ leisure time sun-related cognitions and behaviours. Therefore, the present Protection of Outdoor Workers from Environmental Radiation [POWER]-study aimed to fill these gaps and had the objectives of: a) assessing outdoor workers’ sun-related cognitions and behaviours at work and during leisure time in stringent and less stringent sun protection policy environments; b) assessing the effect of an appearance-based intervention on workers’ risk perceptions, intentions and behaviours over time; c) assessing whether the intervention was equally effective within the two policy settings; and d) assessing the immediate post-intervention effect. Effectiveness was described in terms of changes in sun-related risk perceptions and intentions (as these factors were shown to be main precursors of behaviour change in many health promotion theories) and behaviour. The study purposefully selected and recruited two organisations with a large outdoor worker contingent in Queensland, Australia within a 40 kilometre radius of Brisbane. The two organisations differed in the stringency of implementation and reinforcement of their organisational sun protection policy. Data were collected from 154 male predominantly Australian born outdoor workers with an average age of 37 years and predominantly medium to fair skin (83%). Sun-related cognitions and behaviours of workers were assessed using self-report questionnaires at baseline and six to twelve months later. Variation in follow-up time was due to a time difference in the recruitment of the two organisations. Participants within each organisation were assigned to an intervention or control group. The intervention group participants received a one-off personalised Skin Cancer Risk Assessment Tool [SCRAT]-letter and a facial UV-photograph with detailed verbal information. This was followed by an immediate post-intervention questionnaire within three months of the start of the study. The control group only received the baseline and follow-up questionnaire. Data were analysed using a variety of techniques including: descriptive analyses, parametric and non-parametric tests, and generalised estimating equations. A 15% proportional difference observed was deemed of clinical significance, with the addition of reported statistical significance (p<0.05) where applicable. Objective 1: Assess and compare the current sun-related risk perceptions, intentions, behaviours, and policy awareness of outdoor workers in stringent and less stringent sun protection policy settings. Workers within the two organisations (stringent n=89 and less stringent n=65) were similar in their knowledge about skin cancer, self efficacy, attitudes, and social norms regarding sun protection at work and during leisure time. Participants were predominantly in favour of sun protection. Results highlighted that compared to workers in a less stringent policy organisation working for an organisation with stringent sun protection policies and practices resulted in more desirable sun protection intentions (less willing to tan p=0.03) ; actual behaviours at work (sufficient use of upper and lower body protection, headgear, and sunglasses (p<0.001 for all comparisons), and greater policy awareness (awareness of repercussions if Personal Protective Equipment (PPE) was not used, p<0.001)). However the effect of the work-related sun protection policy was found not to extend to leisure time sun protection. Objective 2: Compare changes in sun-related risk perceptions, intentions, and behaviours between the intervention and control group. The effect of the intervention was minimal and mainly resulted in a clinically significant reduction in work-related self-perceived risk of developing skin cancer in the intervention compared to the control group (16% and 32% for intervention and control group, respectively estimated their risk higher compared to other outdoor workers: , p=0.11). No other clinical significant effects were observed at 12 months follow-up. Objective 3: Assess whether the intervention was equally effective in the stringent sun protection policy organisation and the less stringent sun protection policy organisation. The appearance-based intervention resulted in a clinically significant improvement in the stringent policy intervention group participants’ intention to protect from the sun at work (workplace*time interaction, p=0.01). In addition to a reduction in their willingness to tan both at work (will tan at baseline: 17% and 61%, p=0.06, at follow-up: 54% and 33%, p=0.07, stringent and less stringent policy intervention group respectively. The workplace*time interaction was significant p<0.001) and during leisure time (will tan at baseline: 42% and 78%, p=0.01, at follow-up: 50% and 63%, p=0.43, stringent and less stringent policy intervention group respectively. The workplace*time interaction was significant p=0.01) over the course of the study compared to the less stringent policy intervention group. However, no changes in actual sun protection behaviours were found. Objective 4: Examine the effect of the intervention on level of alarm and concern regarding the health of the skin as well as sun protection behaviours in both organisations. The immediate post-intervention results showed that the stringent policy organisation participants indicated to be less alarmed (p=0.04) and concerned (p<0.01) about the health of their skin and less likely to show the facial UV-photograph to others (family p=0.03) compared to the less stringent policy participants. A clinically significantly larger proportion of participants from the stringent policy organisation reported they worried more about skin cancer (65%) and skin freckling (43%) compared to those in the less stringent policy organisation (46%,and 23% respectively , after seeing the UV-photograph). In summary the results of this study suggest that the having a stringent work-related sun protection policy was significantly related to for work-time sun protection practices, but did not extend to leisure time sun protection. This could reflect the insufficient level of sun protection found in the general Australian population during leisure time. Alternatively, reactance caused by being restricted in personal decisions through work-time policy could have contributed to lower leisure time sun protection. Finally, other factors could have also contributed to the less than optimal leisure time sun protection behaviours reported, such as unmeasured personal or cultural barriers. All these factors combined may have lead to reduced willingness to take proper preventive action during leisure time exposure. The intervention did not result in any measurable difference between the intervention and control groups in sun protection behaviours in this population, potentially due to the long lag time between the implementation of the intervention and assessment at 12-months follow-up. In addition, high levels of sun protection behaviours were found at baseline (ceiling effect) which left little room for improvement. Further, this study did not assess sunscreen use, which was the predominant behaviour assessed in previous effective appearance-based interventions trials. Additionally, previous trials were mainly conducted in female populations, whilst the POWER-study’s population was all male. The observed immediate post-intervention result could be due to more emphasis being placed on sun protection and risks related to sun exposure in the stringent policy organisation. Therefore participants from the stringent policy organisation could have been more aware of harmful effects of UVR and hence, by knowing that they usually protect adequately, not be as alarmed or concerned as the participants from the less stringent policy organisation. In conclusion, a facial UV-photograph and SCRAT-letter information alone may not achieve large changes in sun-related cognitions and behaviour, especially of assessed 6-12 months after the intervention was implemented and in workers who are already quite well protected. Differences found between workers in the present study appear to be more attributable to organisational policy. However, against a background of organisational policy, this intervention may be a useful addition to sun-related workplace health and safety programs. The study findings have been interpreted while respecting a number of limitations. These have included non-random allocation of participants due to pre-organised allocation of participants to study group in one organisation and difficulty in separating participants from either study group. Due to the transient nature of the outdoor worker population, only 105 of 154 workers available at baseline could be reached for follow-up. (attrition rate=32%). In addition the discrepancy in the time to follow-up assessment between the two organisations was a limitation of the current study. Given the caveats of this research, the following recommendations were made for future research: - Consensus should be reached to define "outdoor worker" in terms of time spent outside at work as well as in the way sun protection behaviours are measured and reported. - Future studies should implement and assess the value of the facial UV-photographs in a wide range of outdoor worker organisations and countries. - More timely and frequent follow-up assessments should be implemented in intervention studies to determine the intervention effect and to identify the best timing of booster sessions to optimise results. - Future research should continue to aim to target outdoor workers’ leisure time cognitions and behaviours and improve these if possible. Overall, policy appears to be an important factor in workers’ compliance with work-time use of sun protection. Given the evidence generated by this research, organisations employing outdoor workers should consider stringent implementation and reinforcement of a sun protection policy. Finally, more research is needed to improve ways to generate desirable behaviour in this population during leisure time.

Travel behavior of workers in Dhaka and their attitude towards road pricing

Dhaka, the capital of Bangladesh, is facing severe traffic congestion. Owing to the flaws in past land use and transport planning decisions, uncontrolled population growth and urbanization, Dhaka’s traffic condition is worsening. Road space is widely regarded in the literature as a utility, so a common view of transport economists is that its usage ought to be charged. Road pricing policy has proven to be effective in managing travel demand, in order to reduce traffic congestion from road networks in a number of cities including London, Stockholm and Singapore. Road pricing as an economic mechanism to manage travel demand can be more effective and user-friendly when revenue is hypothecated into supply alternatives such as improvements to the transit system. This research investigates the feasibility of adopting road pricing in Dhaka with respect to a significant Bus Rapid Transit (BRT) project. Because both are very new concepts for the population of Dhaka, public acceptability would be a principal issue driving their success or failure. This paper explores the travel behaviour of workers in Dhaka and public perception toward Road Pricing with regards to work trips- based on worker’s travel behaviour. A revealed preference and stated preference survey has been conducted on sample of workers in Dhaka. They were asked limited demographic questions, their current travel behaviour and at the end they had been given several hypothetical choices of integrated BRT and road pricing to choose from. Key finding from the survey is the objective of integrated road pricing; subsidies Bus rapid Transit by road pricing to get reduced BRT fare; cannot be achieved in Dhaka. This is because most of the respondent stated that they would choose the cheapest option Walk-BRT-Walk, even though this would be more time consuming and uncomfortable as they have to walk from home to BRT station and also from BRT station to home. Proper economic analysis has to be carried out to find out the appropriate fare of BRT and road charge with some incentive for the low income people.

Travel behaviour of workers in Dhaka and their attitudes towards road pricing

Dhaka, Bangladesh faces chronic traffic congestion Funding for major infrastructure proves challenging This research is investigating feasibility of adopting: -Road Pricing -with significant Bus Rapid Transit (BRT) project

Assessing exposure to polybrominated diphenyl ethers (PBDEs) for workers in the vicinity of a large recycling facility

Increased levels of polybrominated diphenyl ethers (PBDEs) can occur particularly in dust and soil surrounding facilities that recycle products containing PBDEs. This may be the source of increased exposure for nearby workers and residents. To investigate, we measured PBDE levels in soil, office dust and blood of workers at the closest workplace (i.e. within 100m) to a large automotive shredding and metal recycling facility in Brisbane, Australia. The workplace investigated in this study was independent of the automotive shredding facility and was one of approximately 50 businesses of varying types within a relatively large commercial/industrial area surrounding the recycling facility. Concentrations of PBDEs in soils were at least an order of magnitude greater than background levels in the area. Congener profiles were dominated by larger molecular weight congeners; in particular BDE-209. This reflected the profile in outdoor air samples previously collected at this site. Biomonitoring data from blood serum indicated no differential exposure for workers near the recycling facility compared to a reference group of office workers, also in Brisbane. Unlike air, indoor dust and soil sample profiles, serum samples from both worker groups were dominated by congeners BDE-47, BDE-153, BDE-99, BDE-100 and BDE-183 and was similar to the profile previously reported in the general Australian population. Estimated exposures for workers near the industrial point source suggested indoor workers had significantly higher exposure than outdoor workers due to their exposure to indoor dust rather than soil. However, no relationship was observed between blood PBDE levels and different roles and activity patterns of workers on-site. These comparisons of PBDE levels in serum provide additional insight into the inter-individual variability within Australia. Results also indicate congener patterns in the workplace environment did not match blood profiles of workers. This was attributed to the relatively high background exposures for the general Australian population via dietary intake and the home environment.

Exposure to ambient heat and urolithiasis among outdoor workers in Guangzhou, China

Objectives: To assess the impact of exposure to ambient heat on urolithiasis among outdoor workers in a subtropical city of China. Methods: The 2003–2010 health check data of a shipbuilding company in Guangzhou, China were acquired. 190 cases and 760 matched controls were involved in this study. We assessed the relationship between exposure to ambient heat and urolithiasis for different occupations using conditional logistic regression. Results: Spray painters were most likely to develop urolithiasis (OR = 4.4; 95% CI: 1.7, 11.4), followed by smelter workers (OR = 4.0; 95% CI: 1.8, 9.2), welders (OR = 3.7; 95% CI: 1.9, 7.2), production security and quality inspectors (OR = 2.7; 95% CI: 1.4, 3.0), and assemblers (OR = 2.2; 95% CI: 1.1, 4.3). Overall, outdoor workers were more likely to present with urolithiasis compared with indoor employees (p b 0.05). In addition, workers with longer cumulative exposure time (OR = 1.5; 95% CI: 1.2, 1.8) and abnormal blood pressure (OR = 1.6; 95% CI: 1.0, 2.5) had higher risk for urolithiasis. Conclusions: Our findings demonstrate a significant association between exposure to ambient heat and urolithiasis among outdoor working populations. Public health intervention strategies should be developed to specifically target outdoor occupations.

The link between policy and practice in science education : the role of research

Policy has been a much neglected area for research in science education. In their neglect of policy studies, researchers have maintained an ongoing naivete about the politics of science education. In doing so, they often overestimate the implications of their research findings about practice and ignore the interplay between the stakeholders beyond and in-school who determine the nature of the curriculum for science education and its enacted character. Policies for education (and science education in particular) always involve authority and values, both of which raise sets of fascinating questions for research. The location of authority for science education differs across educational systems in ways that affect the role teachers are expected to play. Policies very often value some groups in society over others, as the long history of attempts to provide science for all students testifies. As research on teaching/learning science identifies pedagogies that have widespread effectiveness, the policy issue of mandating these becomes important. Illustrations of successful policy to practice suggest that establishing conditions that will facilitate the intended implementation is critically important. The responsibility of researchers for critiquing and establishing policy for improving the practice of science education is discussed, together with the role research associations could play if they are to claim their place as key stakeholders in science education.

Using concept mapping to scaffold learning for students who experience learning difficulties in science classes

In order to develop scientific literacy students need the cognitive tools that enable them to read and evaluate science texts. One cognitive tool that has been widely used in science education to aid the development of conceptual understanding is concept mapping. However, it has been found some students experience difficulty with concept map construction. This study reports on the development and evaluation of an instructional sequence that was used to scaffold the concept-mapping process when middle school students who were experiencing difficulty with science learning used concept mapping to summarise a chapter of a science text. In this study individual differences in working memory functioning are suggested as one reason that students experience difficulty with concept map construction. The study was conducted using a design-based research methodology in the school’s learning support centre. The analysis of student work samples collected during the two-year study identified some of the difficulties and benefits associated with the use of scaffolded concept mapping with these students. The observations made during this study highlight the difficulty that some students experience with the use of concept mapping as a means of developing an understanding of science concepts and the amount of instructional support that is required for such understanding to develop. Specifically, the findings of the study support the use of multi-component, multi-modal instructional techniques to facilitate the development of conceptual understanding with students who experience difficulty with science learning. In addition, the important roles of interactive dialogue and metacognition in the development of conceptual understanding are identified.

Academic rigour in science assessment tasks

The critical problem of student disengagement and underachievement in the middle years of schooling (Years 4 . 9) has focussed attention on the quality of educational programs in schools, in Australia and elsewhere. The loss of enthusiasm for science in the middle years is particularly problematic given the growing demand for science professionals. Reshaping middle years programs has included an emphasis on integrating Information and Communication Technologies (ICTs) and improving assessment practices to engage students in higher cognitive processes and enhance academic rigour. Understanding the nature of academic rigour and how to embed it in students. science assessment tasks that incorporate the use of ICTs could enable teachers to optimise the quality of the learning environment. However, academic rigour is not clearly described or defined in the literature and there is little empirical evidence upon which researchers and teachers could draw to enhance understandings. This study used a collective case study design to explore teachers' understandings of academic rigour within science assessment tasks. The research design is based on a conceptual framework that is underpinned by socio-cultural theory. Three methods were used to collect data from six middle years teachers and their students. These methods were a survey, focus group discussion with teachers and a group of students and individual semi-structured interviews with teachers. Findings of the case study revealed six criteria of academic rigour, namely, higher order thinking, alignment, building on prior knowledge, scaffolding, knowledge construction and creativity. Results showed that the middle years teachers held rich understandings of academic rigour that led to effective utilisation of ICTs in science assessment tasks. Findings also indicated that teachers could further enhance their understandings of academic rigour in some aspects of each of the criteria. In particular, this study found that academic rigour could have been further optimised by: promoting more thoughtful discourse and interaction to foster higher order thinking; increasing alignment between curriculum, pedagogy, and assessment, and students. prior knowledge; placing greater emphasis on identifying, activating and building on prior knowledge; better differentiating the level of scaffolding provided and applying it more judiciously; fostering creativity throughout tasks; enhancing teachers‟ content knowledge and pedagogical content knowledge, and providing more in-depth coverage of fewer topics to support knowledge construction. Key contributions of this study are a definition and a model which clarify the nature of academic rigour.

Knowledge and attitudes about Vitamin D and impact on sun protection practices among urban office workers in Brisbane, Australia

Background: Sun exposure is the main source of vitamin D. Increasing scientific and media attention to the potential health benefits of sun exposure may lead to changes in sun exposure behaviors. Methods: To provide data that might help frame public health messages, we conducted an online survey among office workers in Brisbane, Australia, to determine knowledge and attitudes about vitamin D and associations of these with sun protection practices. Of the 4,709 people invited to participate, 2,867 (61%) completed the questionnaire. This analysis included 1,971 (69%) participants who indicated that they had heard about vitamin D. Results: Lack of knowledge about vitamin D was apparent. Eighteen percent of people were unaware of the bone benefits of vitamin D but 40% listed currently unconfirmed benefits. Over half of the participants indicated that more than 10 minutes in the sun was needed to attain enough vitamin D in summer, and 28% indicated more than 20 minutes in winter. This was significantly associated with increased time outdoors and decreased sunscreen use. People believing sun protection might cause vitamin D deficiency (11%) were less likely to be frequent sunscreen users (summer odds ratio, 0.63; 95% confidence interval, 0.52-0.75). Conclusions: Our findings suggest that there is some confusion about sun exposure and vitamin D, and that this may result in reduced sun-protective behavior. Impact: More information is needed about vitamin D production in the skin. In the interim, education campaigns need to specifically address the vitamin D issue to ensure that skin cancer incidence does not increase.

Cultivating Innovation through Social Relationships: A Qualitative Study of Outstanding Australian Innovators in Science, Technology and the Creative Industries

In this chapter, we describe and explore social relationship patterns associated with outstanding innovation. In doing so, we draw upon the findings of 16 in-depth interviews with award-winning Australian innovators from science & technology and the creative industries. The interviews covered topics relating to various influences on individual innovation capacity and career development. We found that for all of the participants, innovation was a highly social process. Although each had been recognised individually for their innovative success, none worked in isolation. The ability to generate innovative outcomes was grounded in certain types of interaction and collaboration. We outline the distinctive features of the social relationships which seem to be important to innovation, and ask which ‘social network capabilities’ might underlie the ability to create an optimal pattern of interpersonal relationships. We discuss the implications of these findings for universities, which we argue play a key role in the development of nascent innovators.