Evidence-based practice

Introduction This chapter traces the history of evidence-based practice from its roots in evidence-based medicine to contemporary thinking about the usefulness of such an approach to practice. It defines evidence-based practice and differentiates it from terms such as evidence-based medicine, evidence-based policy and evidence-based healthcare. As evidence-based practice is concerned with identifying ‘good evidence’, this chapter will first describe the nature and production of knowledge, as it is important to understand the subjective nature of knowledge and the research process. The chapter considers the necessary skills for evidence-based practice, and discusses the processes of attaining the necessary evidence and its limitations. We examine the barriers and facilitators to identifying and implementing ‘best practice’ and when evidence-based practice is appropriate to use. The chapter concludes with a discussion about the limitations of evidence-based practice and the potential use of other sources of information to guide practice.

Health protection

Our understanding of how the environment can impact human health has evolved and expanded over the centuries, with concern and interest dating back to ancient times. For example, over 4000 years ago, a civilisation in northern India tried to protect the health of its citizens by constructing and positioning buildings according to strict building laws, by having bathrooms and drains, and by having paved streets with a sewerage system (Rosen 1993). In more recent times, the ‘industrial revolution’ played a dominant role in shaping the modern world, and with it the modern public health system. This era was signified by rapid progress in technology, the growth of transportation and the expansion of the market economy, which lead to the organisation of industry into a factory system. This meant that labour had to be brought to the factories and by the 1820s, poverty and social distress (including overcrowding and infrequent sewage and garbage disposal) was more widespread than ever. These circumstances, therefore, lead to the rise of the ‘sanitary revolution’ and the birth of modern public health (Rosen 1993). The sanitary revolution has also been described as constituting the beginning of the first wave of environmental concern, which continued until after World War 2 when major advances in engineering and chemistry substantially changed the face of industry, particularly the chemical sector. The second wave of environmental concern came in the mid to late 20th century and was dominated by the environmental or ecology movement. A landmark in this era was the 1962 publication of the book Silent Spring by Rachel Carson. This identified for the first time the dramatic effects on the ecosystem of the widespread use of the organochlorine pesticide, DDT. The third wave of environmental concern commenced in the 1980s and continues today. The accelerated rate of economic development, the substantial increase in the world population and the globalisation of trade have dramatically changed the production methods and demand for goods in both developed and developing countries. This has lead to the rise of ‘sustainable development’ as a key driver in environmental planning and economic development (Yassi et al 2001). The protection of health has, therefore, been a hallmark of human history and is the cornerstone of public health practice. This chapter introduces environmental health and how it is managed in Australia, including a discussion of the key generic management tools. A number of significant environmental health issues and how they are specifically managed are then discussed, and the chapter concludes by discussing sustainable development and its links with environmental health.

New strength of competition and innovation : China’s independent television production

The state-owned media system in China has evolved considerably since 1994 when the first independent TV production company was officially registered. Today, there are thousands of independent TV production companies looking for market opportunities in China. Independent production companies have facilitated the circulation of program trade and investment, and in the process have encouraged innovation and professionalization. This paper focuses on the evolution of independents and the changing face of the television market. It discusses the ecology of independent television companies in China and how government regulations are impacting on the TV production market. It argues that independent TV is providing a new strength for China‟s TV market, one often suspected of being imitative, propagandistic and lacking colour.

Social studies disciplinary knowledge: Tensions between state curriculum and national assessment requirements

In this chapter, we are particularly concerned with making visible the general principles underlying the transmission of Social Studies curriculum knowledge, and considering it in light of a high-stakes mandated national assessment task. Specifically, we draw on Bernstein’s theoretical concept of pedagogic models as a tool for analysing orientations to teaching and learning. We introduce a case in point from the Australian context: one state Social Studies curriculum vis-a-vis one part of the Year Three national assessment measure for reading. We use our findings to consider the implications for the disciplinary knowledge of Social Studies in the communities in which we are undertaking our respective Australian Research Council Linkage project work (Glasswell et al.; Woods et al.). We propose that Social Studies disciplinary knowledge is being constituted, in part, through power struggles between different agencies responsible for the production and relay of official forms of state curriculum and national literacy assessment. This is particularly the case when assessment instruments are used to compare and contrast school results in highly visible web based league tables (see, for example, http://myschoolaustralia.ning.com/).

Measuring the success of ABC training in South Africa: A case study in the production of Western Liberal broadcast news values

In 1993 the Australian Broadcasting Corporation was contracted by the Australian Government to assist in the reshaping of the South African Broadcasting Corporation from a state-run broadcaster to a respected and trusted national broadcaster for all people in the newly democratic South Africa. Broadcast journalism training was identified by ABC consultant Bob Wurth as possibly the greatest need for SABC Radio. This thesis examines the ABC's role in South Africa and the effectiveness of its radio journalism training project considering the organisational, structural, cultural and political constraints of the SABC. This thesis will show through interviews and participant observation the difficulties in achieving the production of Western Liberal journalism values at the SABC within the time constraints set by the project funded by the Australian Government and the particular South African morays.

Modelling photochemical production of fine particulates in a toluene/NOx/water vapour system

This work investigates the computer modelling of the photochemical formation of smog products such as ozone and aerosol, in a system containing toluene, NOx and water vapour. In particular, the problem of modelling this process in the Commonwealth Scientific and Industrial Research Organization (CSIRO) smog chambers, which utilize outdoor exposure, is addressed. The primary requirement for such modelling is a knowledge of the photolytic rate coefficients. Photolytic rate coefficients of species other than N02 are often related to JNo2 (rate coefficient for the photolysis ofN02) by a simple factor, but for outdoor chambers, this method is prone to error as the diurnal profiles may not be similar in shape. Three methods for the calculation of diurnal JNo2 are investigated. The most suitable method for incorporation into a general model, is found to be one which determines the photolytic rate coefficients for N02, as well as several other species, from actinic flux, absorption cross section and quantum yields. A computer model was developed, based on this method, to calculate in-chamber photolysis rate coefficients for the CSIRO smog chambers, in which ex-chamber rate coefficients are adjusted by accounting for variation in light intensity by transmittance through the Teflon walls, albedo from the chamber floor and radiation attenuation due to clouds. The photochemical formation of secondary aerosol is investigated in a series of toluene-NOx experiments, which were performed in the CSIRO smog chambers. Three stages of aerosol formation, in plots of total particulate volume versus time, are identified: a delay period in which no significant mass of aerosol is formed, a regime of rapid aerosol formation (regime 1) and a second regime of slowed aerosol formation (regime 2). Two models are presented which were developed from the experimental data. One model is empirically based on observations of discrete stages of aerosol formation and readily allows aerosol growth profiles to be calculated. The second model is based on an adaptation of published toluene photooxidation mechanisms and provides some chemical information about the oxidation products. Both models compare favorably against the experimental data. The gross effects of precursor concentrations (toluene, NOx and H20) and ambient conditions (temperature, photolysis rate) on the formation of secondary aerosol are also investigated, primarily using the mechanism model. An increase in [NOx]o results in increased delay time, rate of aerosol formation in regime 1 and volume of aerosol formed in regime 1. This is due to increased formation of dinitrocresol and furanone products. An increase in toluene results in a decrease in the delay time and an increase in the rate of aerosol formation in regime 1, due to enhanced reactivity from the toluene products, such as the radicals from the photolysis of benzaldehyde. Water vapor has very little effect on the formation of aerosol volume, except that rates are slightly increased due to more OH radicals from reaction with 0(1D) from ozone photolysis. Increased temperature results in increased volume of aerosol formed in regime 1 (increased dinitrocresol formation), while increased photolysis rate results in increased rate of aerosol formation in regime 1. Both the rate and volume of aerosol formed in regime 2 are increased by increased temperature or photolysis rate. Both models indicate that the yield of secondary particulates from hydrocarbons (mass concentration aerosol formed/mass concentration hydrocarbon precursor) is proportional to the ratio [NOx]0/[hydrocarbon]0