A mystery to the medical world : Florence Nightingale, Rosendo Salvado and the risk of civilisation

In 1860 Florence Nightingale conducted a study on the mortality rates of indigenous children attending native colonial schools across the British Empire. Her study was driven by the question: ‘Can we civilise the natives without killing them?’ One colonial school that participated in the survey was New Norcia Benedictine mission in Western Australia. When Rosendo Salvado, the mission’s superintendent, responded, he drew on his daily encounters with the Yuat people, his statistics on the mission residents and his Benedictine philosophy of civilisation and conversion of colonised peoples. The correspondence between Salvado and Nightingale took place in the climate of intense debates about Aboriginal health, colonisation and extinction in Britain and the colonies. While many settlers and colonial observers understood Aboriginal depopulation to be the result of either the vices and diseases of unprincipled Europeans or an unstoppable destiny, whether Divine Providence or natural selection, Nightingale and Salvado shared a belief in practical solutions to what they understood to be a practical problem. Their collaboration is an example of the humanitarian opposition to the racial pessimism of Social Darwinism. They both sought to use the recently influential intellectual discipline of social statistics to support their conviction that Aborigines, if patiently and carefully handled, would survive the admittedly risky process of civilisation.

Arsenic contamination in Bangladesh groundwater: a major environmental and social disaster

In attempting to eliminate disease caused by drinking polluted surface water, millions of shallow surface wells were drilled into the Ganges delta alluvium in Bangladesh. The latest statistics indicate that 80% of Bangladesh and an estimated 40 million people are at risk of arsenic poisoning-related diseases because the ground water in these wells is contaminated with arsenic. The clinical manifestations of arsenic poisoning are myriad, and the correct diagnosis depends largely on awareness of the problem. Patients with melanosis, leuco-melanosis, keratosis, hyperkeratosis, dorsum, non-petting edema, gangrene and skin cancer have been identified. The present article reviews the current arsenic contamination of ground water, hydrological systems, groundwater potential and utilization and environmental pollution in Bangladesh. This paper concludes by clarifying the main actions required to ensure the sustainable development of water resources in Bangladesh

Stroke statistics

This publication is the latest edition of a series of statistical compendia and supplements that document the burden of cardiovascular disease in the United Kingdom. This series of publications, published by the British Heart Foundation, usually focuses on coronary heart disease, but Stroke Statistics is jointly published by the British Heart Foundation and The Stroke Association and focuses on the important and substantial burden of stroke in the United Kingdom.

Stroke Statistics is designed for policy makers, health professionals, medical researchers and anyone else with an interest in stroke or cardiovascular disease. It aims to provide the most recent statistics related to the burden of stroke and to document the geographic, social and ethnic inequalities in the experience of stroke.

Stroke Statistics is divided into five chapters. Chapter 1 documents trends and patterns in stroke mortality and premature mortality. Chapter 2 reports on the morbidity burden of stroke, both in terms of prevalence (the rate of people who have had a stroke in the past) and incidence (the rate of first ever strokes). Chapter 3 describes the burden of stroke on the National Health Service, in terms of drug therapy, hospitalisations and surgical procedures. Chapter 4 provides estimates of the prevalence of risk factors for stroke, broken down by age, sex, socioeconomic status and ethnicity. Details about Government targets to tackle the risk factor status of the population are also provided where available. Chapter 5 provides new estimates, calculated specifically for Stroke Statistics, of the economic cost of stroke to the National Health Service and to the United Kingdom economy.

Regional and social differences in coronary heart disease

This publication provides statistics on regional and social differences in relation to CHD mortality, morbidity, treatment and risk.

Social justice in education in 'new times'

This thesis considers social justice in education in ‘new times’. To facilitate the investigation a number of research questions were pursued. These questions were: • What is meant by the label ‘social justice’? • How is social justice to be understood in contemporary terms? • Are there tensions between traditional and contemporary views of social justice? • How effective are policy developments in delivering social justice via education? • What difference do such policies make at the local level? To answer these questions a critical case analysis of a country community and one of its primary schools was carried out. Data were gathered using a variety of methods. As a researcher who was also a teacher in the school I kept a personal professional journal during 1993 and 1994. During this period I was the teacher in the school with responsibility for curriculum development related to issues of social justice. In 1994 I conducted interviews with twenty students, parents and teachers at the school in relation to social justice issues. I also interviewed the CEO of the town’s Council. A number of relevant Federal and State Government and school policy documents were consulted and an archival search of the local newspaper from 1956 to 1994 was undertaken. Statistical information from the Australian Bureau of Statistics as well as from school records was used. A number of local history books were consulted as well as the minutes of relevant school committee meetings. Contemporary social theory, more specifically the work of Anthony Giddens, provided the major methodological tool. Giddens structuration theory was selected as it provided a way of interpreting society from both macro and micro perspectives, it provided a way of studying the interconnectedness of the individual and society. In addition to this, a metaphor was used as a way of developing an understanding of the data. The river was chosen as the metaphor as it has significance to the case study community and it also provides a way of understanding interconnectedness. At an interpretive level, both social theory and moral philosophy were drawn on, including the work of Geoffrey Sharp, Anthony Giddens and Alisdair MacIntyre. A review of selected literature indicated three main areas of concern in relation to this thesis. We live in a time of constant and ongoing change, understanding how this change impacts on the lives of individuals and society is important. Such an understanding relates directly to issues of ontology. In addition it was necessary to consider schools in these ‘new times’. The literature revealed that the changes occurring in the wider society were related to the changes currently being seen in schools. Specifically this related to the increasing emphasis on economics and on individualism, emphases also reflected in the findings of this thesis. Finally the literature related to social justice was discussed, the focus here was on distributive theories of justice and the way these are reflected in programs such as the DSP. The data, as expressed in the metaphor of the flowing river, revealed dominant and marginal currents in social justice in education in ‘new times’. The dominant social group are the intellectually trained and the dominant issues were related to technology, globalisation and economic and bureaucratic rationalism. In the marginal currents we find the under-employed and the unemployed and marginal issues relating to housing, the black economy, poverty and the survival of rural communities. The data also revealed a marginal tributary running into the river. This tributary shows that social cohesion is still a part of life in ‘new times’, albeit a marginalised part. The dominant and marginal currents in social justice in ‘new times’ reveal changes at a deep cultural level. Social justice in ‘new times’ is set within the limits provided by economic rationalism. Such a position is closely linked to the rise of liberal democracy as a political ideology. A rise which has been on a global scale. This valorizes the individual as compared with the group, and the family as compared to the social whole, within the context of expanded economic groupings and markets. Such an ideological position sees the role of the state as providing the ‘legitimising muscle’ to advance the cause of individuals and their families as compared to larger social groupings. These perceptions were applied in Australia, even under a Labor Government. In this sense social justice policies in ‘new times’ are ideological, they act as a political lever to legitimate economic restructuring. They are policies designed to carry disparate groups forward and together on a common wave of economic reform. They are used to ‘sell’ economic reform as being ‘good’ for all of society. Against the backdrop of economic rationalism and liberal democratic ideals there emerges a language geared to the production of an economically viable self, self image, self identity, self esteem and self confidence. As a result, the sense of identity as ‘social’ is lost from view. This thesis argues that what is needed is a new way of looking at social justice in education. A way that reaches beyond the solutions forwarded by the political Left and the Right. It is about the development of an understanding of the way in which an assimilation of the hyper individual and the social group can result in the emergence of the socially responsible individual. This is a cultural shift that sees the individual/society dualism presented in a new way. The categories enter into a new relationship where the balance shifts away from the individual towards society. A shift to a culture where the individual’s rights and responsibilities are respected within a social whole. Such a cultural shift would result in a curriculum which would build social identity, promoted socially responsible independent thought and make space for creativity and the aesthetic. A ‘curriculum for social responsibility’ would be a socially just curriculum.

Indirect government controls over Australia's social security expenditure : a Foucauldian analysis

Purpose – The aim of this study is to examine how the use of indirect government control mechanisms is used as a means of holding government agencies such as job network providers and recipients of social security benefits accountable. The mechanisms of indirect government will be examined using Michel Foucault's discourses on disciplinary power, surveillance and normalisation.

Design/methodology/approach – The mechanisms of indirect government are investigated through a survey questionnaire and focus group interviews. The questionnaire is assessed and analysed using descriptive statistics and principal component analysis with varimax rotation.

Findings – It is found that the rationing and disciplinary mechanisms of the breaching regime, through a process of disciplinary power, surveillance and normalisation, combine to help hold government agencies and recipients of social security benefits accountable, which in turn helps control the level of social security expenditure.

Originality/value – The current study extends our understanding of the functions of indirect government by providing an applied example of how the process of government works indirectly through government agencies and the abundant rules and regulations that underpin such bureaucracies.

Social disadvantage, bone mineral density and vertebral wedge deformities in the Tasmanian Older Adult Cohort

Summary The relationship between social disadvantage and bone mineral density (BMD) is complex and remains unclear; furthermore, little is known of the relationship with vertebral deformities. We observed social disadvantage to be associated with BMD for females, independent of body mass index (BMI). A lower prevalence of vertebral deformities was observed for disadvantaged males.

Introduction The relationship between social disadvantage and BMD appears complex and remains unclear, and little is known about the association between social disadvantage and vertebral wedge deformities. We examined the relationship between social disadvantage, BMD and wedge deformities in older adults from the Tasmanian Older Adult Cohort.

Methods BMD and wedge deformities were measured by dual-energy X-ray absorptiometry and associations with extreme social disadvantage was examined in 1,074 randomly recruited population-based adults (51 % female). Socioeconomic status was assessed by Socio-economic Indexes for Areas values derived from residential addresses using Australian Bureau of Statistics 2001 census data. Lifestyle variables were collected by self-report. Regression models were adjusted for age, BMI, dietary calcium, serum vitamin D (25(OH)D), smoking, alcohol, physical inactivity, calcium/vitamin D supplements, glucocorticoids and hormone therapy (females only).

Results Compared with other males, socially disadvantaged males were older (65.9 years versus 61.9 years, p = 0.008) and consumed lower dietary calcium and alcohol (both p ≤ 0.03). Socially disadvantaged females had greater BMI (29.9 ± 5.9 versus 27.6 ± 5.3, p = 0.002) and consumed less alcohol (p = 0.003) compared with other females. Socially disadvantaged males had fewer wedge deformities compared with other males (33.3 % versus 45.4 %, p = 0.05). After adjustment, social disadvantage was negatively associated with hip BMD for females (p = 0.02), but not for males (p = 0.70), and showed a trend for fewer wedge deformities for males (p = 0.06) but no association for females (p = 0.85).

Conclusions Social disadvantage appears to be associated with BMD for females, independent of BMI and other osteoporosis risk factors. A lower prevalence of vertebral deformities was observed for males of extreme social disadvantage. Further research is required to elucidate potential mechanisms for these associations.

Using social network analysis to identify key child care center staff for obesity prevention interventions: a pilot study

Introduction. Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method. Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) within centers, via an eight item closed-ended social network questionnaire. Questionnaire data were collected from (17/20; response rate 85%) long day care center staff. Social network density and centrality statistics were calculated, using UCINET social network software, to examine the role of networks in obesity prevention. Results. “Degree” (influence) and “betweeness” (gatekeeper) centrality measures of staff inter-relationships about physical activity, dietary, and policy information identified key players in each center. Network density was similar and high on some relationship networks in both centers but markedly different in others, suggesting that the network tool identified unique center social dynamics. These differences could potentially be the focus of future team capacity building. Conclusion. Social network analysis is a feasible and useful method to identify existing obesity prevention networks and key personnel in long day care centers.

A web-based, social networking physical activity intervention for insufficiently active adults delivered via Facebook app: randomized controlled trial

BACKGROUND: Online social networks offer considerable potential for delivery of socially influential health behavior change interventions. OBJECTIVE: To determine the efficacy, engagement, and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app. METHODS: A total of 110 adults with a mean age of 35.6 years (SD 12.4) were recruited online in teams of 3 to 8 friends. Teams were randomly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring, social elements, and pedometers ("Active Team" Facebook app; n=51 individuals, 12 teams) or a wait-listed control condition (n=59 individuals, 13 teams). Assessments were undertaken online at baseline, 8 weeks, and 20 weeks. The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity (MVPA). Secondary outcomes were weekly walking, vigorous physical activity time, moderate physical activity time, overall quality of life, and mental health quality of life. Analyses were undertaken using random-effects mixed modeling, accounting for potential clustering at the team level. Usage statistics were reported descriptively to determine engagement and feasibility. RESULTS: At the 8-week follow-up, the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group (P=.03), due primarily to increases in walking time (155 min/week increase relative to controls, P<.001). However, statistical differences between groups for total weekly MVPA and walking time were lost at the 20-week follow-up. There were no significant changes in vigorous physical activity, nor overall quality of life or mental health quality of life at either time point. High levels of engagement with the intervention, and particularly the self-monitoring features, were observed. CONCLUSIONS: An online, social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes. Future work is needed to determine how to maintain behavior change in the longer term, how to reach at-need populations, and how to disseminate such interventions on a mass scale. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000488606; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366239 (Archived by WebCite at http://www.webcitation.org/6ZVtu6TMz).

Addressing migration-related social and health inequalities in Australia: call for research funding priorities to recognise the needs of migrant populations

Objective Migrants constitute 26% of the total Australian population and, although disproportionately affected by chronic diseases, they are under-represented in health research. The aim of the present study was to describe trends in Australian Research Council (ARC)- and National Health and Medical Research Council (NHMRC)-funded initiatives from 2002 to 2011 with a key focus on migration-related research funding.Methods Data on all NHMRC- and ARC-funded initiatives between 2002 and 2011 were collected from the research funding statistics and national competitive grants program data systems, respectively. The research funding expenditures within these two schemes were categorised into two major groups: (1) people focused (migrant-related and mainstream-related); and (2) basic science focused. Descriptive statistics were used to summarise the data and report the trends in NHMRC and ARC funding over the 10-year period.Results Over 10 years, the ARC funded 15 354 initiatives worth A$5.5 billion, with 897 (5.8%) people-focused projects funded, worth A$254.4 million. Migrant-related research constituted 7.8% of all people-focused research. The NHMRC funded 12 399 initiatives worth A$5.6 billion, with 447 (3.6%) people-focused projects funded, worth A$207.2 million. Migrant-related research accounted for 6.2% of all people-focused initiatives.Conclusions Although migrant groups are disproportionately affected by social and health inequalities, the findings of the present study show that migrant-related research is inadequately funded compared with mainstream-related research. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce these inequalities among migrants.What is known about the topic? Immigration is on the rise in most developing countries, including Australia, and most migrants come from low- and middle-income countries. In Australia, migrants constitute 26% of the total Australian population and include refugee and asylum seeker population groups. Migrants are disproportionately affected by disease, yet they have been found to be under-represented in health research and public health interventions.What does this paper add? This paper highlights the disproportions in research funding for research among migrants. Despite migrants being disproportionately affected by disease burden, research into their health conditions and risk factors is grossly underfunded compared with the mainstream population.What are the implications for practitioners? Migrants represent a significant proportion of the Australian population and hence are capable of incurring high costs to the Australian health system. There are two major implications for practitioners. First, the migrant population is constantly growing, therefore integrating the needs of migrants into the development of health policy is important in ensuring equity across health service delivery and utilisation in Australia. Second, the health needs of migrants will only be uncovered when a clear picture of their true health status and other determinants of health, such as psychological, economic, social and cultural, are identified through empirical research studies. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce health and social inequalities among migrant communities.

Social exclusion of Australian childless women in their reproductive years

Research suggests Australian childless women are at risk of pronatalism-driven social exclusion. This exploratory, mixed methods, cross-sectional study described and explored the social exclusion of Australian childless women aged 25 to 44 years, and asked: what are the nature and extent of social exclusion of childless women; and do the nature and extent of exclusion vary for different types of childless women? A total of 776 childless female Australian residents aged 25 to 44 years completed a self-administered questionnaire. Quantitative data were collected on childlessness types, indicators of exclusion and perceived stigmatisation and exclusion due to being childless. Data were analysed using descriptive statistics, One Way ANOVAs and Kruskal Wallis Analysis of Ranks. Qualitative data on childless women’s experiences were inductively thematically analysed. Findings suggest societal-level pronatalism drives exclusion of Australian childless women. While exclusion occurs in all domains of life, childless women experience more exclusion, and perceive more exclusion due to being childless, in the social and civic domains than the service and economic domains. Circumstantially and involuntarily childless women, followed by voluntarily childless women, perceive more exclusion due to being childless than undecided and future childed women. Experiences are influenced by the nature of women’s ‘deviance’ from pronatalism.

Modified CADF and CIPS panel unit root statistics with standard chi-squared and normal limiting distributions

In an influential paper Pesaran ('A simple panel unit root test in presence of cross-section dependence', Journal of Applied Econometrics, Vol. 22, pp. 265-312, 2007) proposes two unit root tests for panels with a common factor structure. These are the CADF and CIPS test statistics, which are amongst the most popular test statistics in the literature. One feature of these statistics is that their limiting distributions are highly non-standard, making for relatively complicated implementation. In this paper, we take this feature as our starting point to develop modified CADF and CIPS test statistics that support standard chi-squared and normal inference.

Social research: strength of evidence rating tool

This document provides guidelines for the Victorian Auditor-General's Office when it comes to propose or evaluate social research in the areas of sampling, questionnaires, interviews, focus groups, consulting with a group, descriptive and inferential statistics, document reviews and non-participatory observation.