Special report : the wellbeing of Australians : groups with the highest and lowest wellbeing in Australia

Overview and Aim
1. This report concerns an analysis of the cumulative data from 15 surveys using the Personal Wellbeing Index to measure Subjective Wellbeing. The total number of respondents is about 30,000 but not all data were available for all analyses due to changing variables between
surveys.
2. The aim of this analysis is to determine those sub-groups with the highest and the lowest wellbeing.
Method
3. The definition of sub-groups is through the demographic variables of Income, Gender, Age, Household Composition, Relationship Status and Employment Status. Index domains are also included. While not every combination of demographic variables has been tested, the total number of combinations analysed was 3,277.
4. Extreme group mean scores are defined as lying above 79 points and below 70 points. These values are at least five standard deviations beyond the total sample mean score and are, therefore, extreme outliers. The minimum number of responses that could form such a group is
one. Data are accumulated across surveys for corresponding groups.
Results
5. The initial search for the most extreme groups identified the 20 highest and the 20 lowest groups with a minimum N=10. These are termed the ‘Exclusive’ groups since they were based only on the previously identified extreme scores. In order to determine the true mean of each of these groups, a further analysis incorporated all respondents who met the definition of group membership. For example, an Exclusive group defined as [male, 76+ years] would contain only the accumulation of scores from individual surveys that met the extreme score criterion (<70 or >79). The Inclusive group included the scores from all survey respondents who matched the group definition of male, 76+ years.
6. The results revealed a dominance by the domains of the Personal Wellbeing Index. The extreme high groups were predicted by high scores on all domains except safety and relationships. The low groups were defined by low scores on all seven domains.
7. A further search for extreme groups was undertaken that was restricted to the demographic descriptors. The 20 highest and 20 lowest groups were identified based on a minimum cell content of N=10. The corresponding Inclusive group means were then calculated as before.
8. In order to increase the reliability of the final groups, a minimum cell content of N=20 cases was imposed.
9. Six extreme high groups were identified. These are dominated by high income and the presence of a partner. Five extreme low groups were identified. These are dominated by very low income, the absence of a partner, and unemployment.
Conclusions
10. The conclusions drawn from these analyses are as follows:
10.1 The central defining characteristics of people forming the extreme high wellbeing groups is high household income and living with a partner.
10.2 The central defining risk factors for people forming the extreme low wellbeing groups are very low household income, not living with a partner, and unemployment.
10.3 None of these five demographic characteristics are sufficient to define extreme wellbeing groups on their own. They all act in combinations of at least two risk factors together.

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

Background: Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA), there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical function and health-related quality of life, and slower structural disease progression as well as being more cost-effective, than control flat insoles in people with medial knee OA.

Methods/Design: Two hundred participants with painful radiographic medial knee OA and varus malalignment will be recruited from the community and randomly allocated to lateral wedge or control insole groups using concealed allocation. Participants will be blinded as to which insole is considered therapeutic. Blinded follow up assessment will be conducted at 12 months after randomisation. The outcome measures are valid and reliable measures recommended for OA clinical trials. Questionnaires will assess changes in pain, physical function and health-related quality-of-life. Magnetic resonance imaging will measure changes in tibial cartilage volume. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log-book returned to the assessor on a monthly basis. To test the effect of the intervention using an intention-to-treat analysis, linear regression modelling will be applied adjusting for baseline outcome values and other demographic characteristics.

Discussion: Results from this trial will contribute to the evidence regarding the effectiveness of laterally wedged insoles for the management of medial knee OA.

Trial registration: ACTR12605000503628; NCT00415259.

Hope of a nation - experiences of social exclusion giving rise to spaces of inclusion for people living with HIV and AIDs in South Africa : a reflection

South Africa has one of the highest rates of HIV/AIDS in the world. No one particular group is affected by the virus – rather, it is indiscriminate. Responses to HIV are diverse, and can be starkly contradictory. This author lived among the Xhosa people in rural Eastern Cape, working in community development. The program was a population-based youth empowerment program around HIV prevention. The work involved engaging youth in a range of civic participation activities, and networking with other community based groups and organisations, health and social services, and government departments. This reflection out a narrative of the lived experiences of social exclusion and social connectedness for people living with HIV/AIDS in rural Eastern Cape. It draws out the paradox of how the high prevalence of stigma and discrimination towards those with the illness, and their subsequent experience of social exclusion, actually creates opportunities for social connectedness through support group participation. This in turn is fashioning an emerging social movement breaking down barriers of stigma, and contributing to broader social change to support HIV action.

The reflection begins by outlining the current context and underlying determinants of the proliferation of HIV in the Eastern Cape, including a discussion of exclusion as a determinant. An exploration of how exclusion is also experienced as an outcome of positive HIV status follows. Finally, an explanation of how the experience of exclusion can be transformed into spaces of connectedness, and implications for health promotion practice in this context is also presented.

Selection of priority groups for obesity prevention current approaches and development of an evidence-informed framework

Resources for obesity prevention interventions are inevitably limited, necessitating the selection of priority groups to ensure effective and equitable use of funds. This paper aims to review published approaches to selection of priority groups ('target populations') for obesity prevention, and to present the development of a new systematic framework for organizing and assessing evidence for selecting priority groups. A review was conducted of the process and justification described for selecting priority groups in a sample of obesity prevention publications. Using the results of this review and adaptation of theory and frameworks in both the obesity prevention and health promotion priority-setting literature, a framework was developed for assessment of potential priority groups for obesity prevention. The published literature lacks discussion of and explicit processes for selection of priority groups for obesity prevention intervention. The new framework describes specific types of evidence that should be considered in the assessment of a potential priority group for obesity prevention and has applications for funding and implementing community-based or settings-level obesity prevention interventions and research. Application of this framework has the potential to enhance the effective use of limited obesity prevention resources and to identify areas in need of additional research evidence.

Online discussion in engineering education : student responses and learning outcomes

A ubiquitous and widely used feature of online learning environments is the asynchronous discussion board. This chapter presents a case study of the introduction and evaluation of student use of an online discussion in an engineering management study unit. We introduced an assessable assignment task based on student use of an online discussion, in response to falling student unit evaluation results after we initially moved the unit to wholly online delivery mode. Both quantitative and qualitative unit evaluation data suggest that students perceive value in the online discussion activities. A regression analysis based on discussion usage data suggests that students derived significant learning outcome benefit toward their final unit grade from making reflective postings in the online discussion.

Challenging capacity building : comparative perspectives

The focus of most capacity building programs is poor and disadvantaged communities. However, the appropriateness of capacity building for these groups, whether located in "developing" or "developed" countries, is always presented as self-evident. In much of the discussion of "how to" build capacity, critical questions regarding the determination of whose capacities are to be built, the methods by which capacity will be built and the consequences for wider relationships of those whose capacity is being built (and presumably for those whose capacity is being left to be built at another time!) are not investigated. A deeper understanding of the meaning, practice and potential of capacity building is required. This book challenges capacity building by critically interrogating its central ideas and practices. But it also considers the ways in which capacity building itself can challenge disadvantage and inequality, by offering a self-determining way forward for communities.

Democratizing health : consumer groups in the policy process

This timely book examines the role of consumer organisations in the health policy process. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratisation in the health domain. Their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively exploring the opportunities and dilemmas of this type of activism, including sometimes ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative frameThis book examines the important role of consumer activism within health policy in different national contexts. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratization in the health domain. The expert contributors explore how their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively analysing the opportunities and dilemmas of this type of activism, including ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative framework, with case studies from various countries. work, with case studies from many countries.

Introduction : consumer groups and the democratization of health policy

This book examines the important role of consumer activism within health policy in different national contexts. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratization in the health domain. The expert contributors explore how their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively analysing the opportunities and dilemmas of this type of activism, including ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative framework, with case studies from various countries. Students and researchers in the fields of health policy and sociology, public policy and social movements will find this relevant and path-breaking book enlightening. It will also prove invaluable for participants and activists in patient and health consumer organizations.

From activism to state inclusion : health consumer groups in Australia

This book examines the important role of consumer activism within health policy in different national contexts. In an age of shifting boundaries between state and civil society, consumer groups are potentially drivers of democratization in the health domain. The expert contributors explore how their activities bring new dynamics to relations between service providers, the medical profession, government agencies, and other policy actors. This book is unique in comprehensively analysing the opportunities and dilemmas of this type of activism, including ambiguous partnerships between consumer groups and stakeholders such as the pharmaceutical industry. These themes are explored within an internationally comparative framework, with case studies from various countries. Students and researchers in the fields of health policy and sociology, public policy and social movements will find this relevant and path-breaking book enlightening. It will also prove invaluable for participants and activists in patient and health consumer organizations.

Emotional connections to books and technological innovations : an e-book perspective

E-book devices are a technological innovation that has been mass marketed to consumers as a revolution in the way that books will be read and stored. This paper extends previous research on technology adoption behaviour of individuals by focusing on the role of emotional connections people have towards e-books. A number of technology adoption models can explain the adoption of e-book devices such as the technology acceptance model, theory of planned action, theory of reasoned action and social cognitive theory. Due to the increased importance of social learning on a person’s behaviour, social cognitive theory is identified in this paper as being the most appropriate theoretical lens to understand the emotional connections a person has towards e-books. The findings from this paper may help to fill the gaps in academic discussion about what theory best explains a person’s behavioural intention towards technological innovations and the impact of marketing on this behaviour. In addition, the paper has a number of managerial implications including identifying the importance of an emotional connection to a technological innovation that influences the adoption process. The emphasis on emotional connection as mediating the way a person receives information about e-book devices may help to influence future marketing efforts of new technologies.

The future of diversity and difference : can the national curriculum for English be hospitable?

This chapter explores the context of constructing the Australian Curriculum: English and how it represents and responds to the diversity of students. It starts with the brief genealogy of neoliberal standards-based reforms as a way of managing differences. In doing so, the chapter situates the national agenda of curriculum reforms in the semiotic order of ‘risk societies’ (Beck, 1992) through which various risks are both manufactured and managed. The semiotic order of managing educational risks through reforms is presented as a discursive force-field that both creates ‘moral panics’ and provides solutions, thereby appealing to the broader public and securing its consent. This discussion prepares the ground for the reading of texts produced in the lead-up to the actual release of the national curriculum for English and statements about diversity in these documents as well as in the curriculum itself. The chapter then goes on to explore what might be possible in the process of the curriculum implementation, by drawing on ideas of hospitality, responsibility and dialogism. In conclusion, this essay argues that no national curriculum can be successfully implemented unless it is sensitive to the textual and cultural practices of other groups and unless it wins their political consent. Equally, no national curriculum can be ethically implemented unless it recognises and responds to difference and unless it creates a possibility of transcending the logic of the Same.

Facing off : facebook and higher education

A social and cultural expectation that Information Communication Technologies (ICT) should be ubiquitous within peoples' daily lives is apparent. Connecting generational groups with a specific set of technological attributes also assumes the ways that particular groups of students should be able/do “naturally” use emergent mobile and social technologies. Moreover, the use of social networking technologies is evident in a number of ways within higher education (HE) pedagogies. As part of the suite of possibilities in Web 2.0, Facebook is used in a number of ways to support communications within and between institutions and their students as well as a mechanism for teaching and learning within specific units of study.

The chapter commences with a broad discussion about social sharing software of Web 2.0, specifically Facebook, as a potential teaching and learning tool in HE contexts. We traverse recent exemplars and discourses surrounding the use of social technologies for the purposes of HE. It is clear from the literature that while there is much excitement at the possibilities that such technologies offer, there are increasing anxieties across institutional and individual practitioners, in regard to possible consequences of their use.

Through autoethnographic methodology, this chapter showcases potentials and challenges of Facebook in HE. Through the use of constructed scenarios, the authors describe occurrences that necessitate increasing professional development and vigilance online. Some of the issues highlighted within this chapter include blurring of professional and personal life world boundaries, issues of identity theft and vandalism, cyberstalking and bullying, working in the public domain, and questions of virtual integrity.

Health system costs of diseases and injury in Australia 1993-94 : an analysis of costs, service use and mortality for major disease and injury groups

Provides a systematic analysis of the health system use and costs associated with specific disease and injury groups in Australia in 1993-94. The estimates are presented in a consistent format and are derived using a methodology that ensures the results add across disease, age and sex groups to total Australian health expenditures for 1993-94.