Psychosocial risk factors for coronary heart disease: a consensus statement from the National Heart Foundation of Australia

In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD.

Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive.

Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD.

Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study.

Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.

Pop, heavy metal and the blues: secondary analysis of persistent organic pollutants (POP), heavy metals and depressive symptoms in the NHANES National Epidemiological Survey

Persistent environmental pollutants, including heavy metals and persistent organic pollutants (POPs), have a ubiquitous presence. Many of these pollutants affect neurobiological processes, either accidentally or by design. The aim of this study was to explore the associations between assayed measures of POPs and heavy metals and depressive symptoms. We hypothesised that higher levels of pollutants and metals would be associated with depressive symptoms.

The Popular Education Network of Australia (PENA) and Twenty-First-Century critical education

Drawing on the philosophies and writings of Paulo Freire regarding education as activism, this paper will explore the history and activities of the Popular Education Network of Australia (PENA). The network, founded in 2009, involves educators, academics and community workers, working together on issues relating to critical pedagogy and social change in schools, communities and adult education contexts. Two symposia have been organised on critical education in Australia. In 2010, ‘Teaching and Learning for Social Justice and Action’ was the inaugural gathering. In 2012, ‘Freire Reloaded: Learning and Teaching to Change the World’ featured a diverse range of workshops and Professor Antonia Darder as keynote speaker and observer. Through the perspectives and experiences of five academics involved in PENA, this paper will explore the group’s activities and reflect on the inspiration drawn from the work of Freire, Darder and others. Creating spaces for discussion of critical pedagogy affords opportunities for academics, educators, teachers and activists to reflect on their practice and also leads to further spontaneous networking and planning of action. In this paper we argue that there is continuing importance, in fact urgency, in producing places and spaces for conscientisation to occur, and for examples of critical education to be shared amongst 21st century educators.

The correlation between stacking fault energy and the work hardening behaviour of high-mn twinning induced plasticity steel tested at various temperatures

High-Mn Twinning Induced Plasticity (TWIP) steels have superior mechanical properties, which make them promising materials in automotive industry to improve the passenger safety and the fuel consumption. The TWIP steels are characterized by high work hardening rates due to continuous mechanical twin formation during the deformation. Mechanical twinning is a unique deformation mode, which is highly governed by the stacking fault energy (SFE). The composition of steel alloy was Fe-18Mn-0.6C-1Al (wt.%) with SFE of about 25-30 mJ/m2 at room temperature. The SFE ensures the mechanical twinning to be the main deformation mechanism at room temperature. The microstructure, mechanical properties, work hardening behaviour and SFE of the steel was studied at the temperature range of ambient ≤T[°C]≤ 400°C. The mechanical properties were determined using Instron tensile testing machine with 30kN load cell and strain rate of 10-3s-1 and the work hardening behaviour curves were generated using true stress and true strain data. The microstructure after deformation at different temperatures was examined using Zeiss Supra 55VP SEM. It was found that an increase in the deformation temperature raised the SFE resulting in the deterioration of the mechanical twinning that led to decrease not only in the strength but also in the total strain of the steel. A correlation between the temperature, the SFE, the mechanical twinning, the mechanical properties and the work hardening rate was also found. © (2014) Trans Tech Publications, Switzerland.

Introduction: IP and the Asia-Pacific ‘spaghetti bowl’ of free trade agreements

The contributions to this book show the strategies and policies of countries in the Asia-Pacific region that have to grapple with international standard setting in what has been called the ‘spaghetti bowl’ of criss-crossing free trade agreements. The chapters show how intellectual property is just one among many political and economic factors that are used in trade off discussions. It leads to an often considerable further raising of IP standards in those countries that agree to higher protection levels, often for reasons that have little to do with the provision of incentives for technological progress. A more nuanced picture of IP protection in Asia shows the different interests of high protection countries, ‘first’ and ‘second tier’ newly industrialized and industrializing countries and the rather peculiar position of Australia and New Zealand. The chapter introduces the contributions to this volume according to these various groups of countries and of international law and the political economy of the region.

A review of the relationship between socioeconomic position and the early-life predictors of obesity

A range of important early-life predictors of later obesity have been identified. Children of lower socioeconomic position (SEP) have a steeper weight gain trajectory from birth with a strong socioeconomic gradient in child and adult obesity prevalence. An assessment of the association between SEP and the early-life predictors of obesity has been lacking. The review involved a two-stage process: Part 1, using previously published systematic reviews, we developed a list of the potentially modifiable determinants of obesity observable in the pre-natal, peri-natal or post-natal (pre-school) periods; and part 2, conducting a literature review of evidence for socioeconomic patterning in the determinants identified in part 1. Strong evidence was found for an inverse relationship between SEP and (1) pre-natal risk factors (pre-pregnancy maternal body mass index (BMI), diabetes and pre-pregnancy diet), (2) antenatal/peri natal risk factors (smoking during pregnancy and low birth weight) and (3) early-life nutrition (including breastfeeding initiation and duration, early introduction of solids, maternal and infant diet quality, and some aspects of the home food environment), and television viewing in young children. Less strong evidence (because of a lack of studies for some factors) was found for paternal BMI, maternal weight gain during pregnancy, child sleep duration, high birth weight and lack of physical activity in young children. A strong socioeconomic gradient exists for the majority of the early-life predictors of obesity suggesting that the die is cast very early in life (even pre-conception). Lifestyle interventions targeting disadvantaged women at or before child-bearing age may therefore be particularly important in reducing inequality. Given the likely challenges of reaching this target population, it may be that during pregnancy and their child's early years are more feasible windows for engagement.

'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities.

AIMS AND OBJECTIVES: To systematically examine, describe and explain how continence care was determined, delivered and communicated in Australian long aged care facilities. BACKGROUND: Incontinence is a highly stigmatising condition that affects a disproportionally large number of people living in long-term aged care facilities. Its day-to-day management is mainly undertaken by careworkers. We conducted a Grounded theory study to explore how continence care was determined, delivered and communicated in long-term aged care facilities. This paper presents one finding, i.e. how careworkers in long-term aged care facilities deal with the stigma, devaluation and the aesthetically unpleasant aspects of their work. DESIGN: Grounded theory. METHODS: Eighty-eight hours of field observations in two long-term aged care facilities in Australia. In addition, in-depth interviews with 18 nurses and careworkers who had experience of providing, supervising or assessment of continence care in any long-term aged care facility in Australia. RESULTS: Occupational exposure to incontinence contributes to the low occupational status of carework in long-term aged care facilities, and continence care is a symbolic marker for inequalities within the facility, the nursing profession and society at large. Careworkers' affective and behavioural responses are characterised by: (1) accommodating the context; (2) dissociating oneself; (3) distancing oneself and (4) attempting to elevate one's role status. CONCLUSION: The theory extends current understandings about the links between incontinence, continence care, courtesy stigma, emotional labour and the low occupational status of carework in long-term aged care facilities. RELEVANCE TO CLINICAL PRACTICE: This study provides insights into the ways in which tacit beliefs and values about incontinence, cleanliness and contamination may affect the social organisation and delivery of care in long-term aged care facilities. Nurse leaders should challenge the stigma and devaluation of carework and careworkers, and reframe carework as 'dignity work'.

No prospect of release: Kevin Crump and the human rights implications of life imprisonment

A NSW court last week dismissed Kevin Crump’s latest appeal against his natural life sentence. Crump, who has served nearly 42 years in prison for murder, has been formally denied any prospect of a meaningful life outside prison walls.

The decision provides a timely opportunity to reconsider the viability of terms of life without parole. It further entrenches the use of terms of life without parole in Australia despite moves overseas to restrict – and in some cases eradicate – them.

The relationship between divorce and the psychological well‐being of children with ADHD: differences in age, gender, and subtype

It is generally accepted that Attention‐Deficit/Hyperactivity Disorder (ADHD) results from a dysfunction of the central nervous system, which has led to a commonly held belief that environmental factors play little role in the behavioural problems of children identified as having ADHD. Therefore, the two studies reported in this article investigated the relationship between parental divorce and the psychological well‐being of children with ADHD. Subjects, aged 6 to 18 years, were diagnosed with either the inattentive or combined subtype of the disorder. Firstly, differences in children's behaviour between divorced and non‐divorced families were examined, and subtype, age, and gender differences were evaluated in terms of symptom severity and comorbid conditions. Secondly, parents' perceptions of the impact of their children's behaviour on marital status and family/parental functioning were examined. Parental divorce was associated with greater symptom severity, more externalizing/ internalizing behaviours, and poorer social functioning, but less with academic underachievement. Further, parental divorce was related to adjustment differences in ADHD subtypes, age, and gender. However, the correlation between behaviour problems of children with ADHD and marital/family dysfunction was weak. It may be concluded that parental divorce was associated with the psychological well‐being in children with ADHD, and there is some suggestion that ADHD should be viewed as a bio‐psychosocial disorder.

Country brand and stakeholder engagement: Case study of Australia unlimited

The thesis presents a comprehensive conceptual framework of stakeholder brand engagement with a place brand identity. The framework comprises of typology of stakeholder brand engagement in place branding context as well as drivers, inhibitors, manifestations and outcomes of such engagement.

Heritagescaping and the aesthetics of refuge: challenges to urban sustainability

The year 2012 marked the fortieth anniversary of UNESCO’s Convention Concerning the Protection of the World Cultural and Natural Heritage, or World Heritage
Convention. Regarded by many as a hugely successful project, World Heritage has
provided a framework for safeguarding a wide array of historic built environments.
The choice of “sustainable development and the role of communities” as the theme of
the fortieth anniversary was, however, recognition of the significant problems and
challenges this arena of cultural and spatial governance has created for those living in
and around listed sites. Cities have proved particularly challenging, and resistant to
prescriptive modeling at the level of international policy. Evictions, punitive
legislation, rising living costs, and loss of community are the now familiar by‐products of worldheritage that continue to go undocumented and ignored.
Against this backdrop, this chapter traces recent developments and trends surrounding urban heritage conservation, highlighting recent turns towards community‐driven approaches and discourses of sustainability. It then raises the issue of gentrification, with a particular focus on where such problems take on critical importance: small‐scale urban environments. Focusing on Galle in Sri Lanka, the final part of the chapter explores the emergence of a form of “heritagescaping” oriented by an aesthetics of solitude, tran-quility, and quiet comfort. In offering a contribution towards debates around urban sustainability and the role of heritage therein, it is argued that such processes present significant obstacles to the development of more community‐based, culturally sustainable forms of heritage conservation.