Strategic directions report for the social determinants of health project

This report presents the outcomes of a project undertaken by the VACCHO Public Health Research Unit to explore ways to build capacity in Aboriginal and Torres Strait Islander social determinants research. The project was funded by the Cooperative Research Centre for Aboriginal Health.----- The project involved a series of four social determinants research workshops conducted in July and August 2009 and a collaborative forum conducted in September 2009. Invitations to participate were extended to the VACCHO membership and the nine universities in Victoria. Three workshops were held with ACCHOs (in Bendigo, Melbourne and Gippsland), and one workshop with universities (in Melbourne).----- The workshops aimed to build VACCHO���s social determinants research capacity and provide direction for VACCHO on ways to more effectively engage in Aboriginal health research. Through the workshops, VACCHO aimed to work with ACCHOs to identify research processes and issues that are equitable and sustainable, and which address the social determinants of health.----- At the workshops, participants explored questions around the priorities for the social determinants of Aboriginal health and considered the key partnerships that might be important to social determinants research.----- At the workshops with ACCHOs, participants identified key research priorities and questions in Aboriginal social determinants and health. This focus reflects the need for Aboriginal and Torres Strait Islander community representatives to identify the priorities in health and social determinants research. Identifying these priorities is important if researchers are to respond in a meaningful way and undertake relevant research in the most urgent areas of need. At the university workshop, participants focused on identifying research process and implementation issues in social determinants research.----- The final forum brought together ACCHOs, university representatives, invited presenters and participants from justice, education and housing departments, and representatives from non-government funding organisations. The forum aimed to provide an insight into how priorities and funding decisions are made, and how research can help to ensure they are influenced by the priorities of the community. The findings from the workshops were presented at the forum and used to develop pathways for future research.

Ethics on-the-run

Midwives are involved in a very dynamic profession. As they face their everyday tasks they encounter many different situations and a variety of people which results in a vast number of interactions. This narrative research project sought to identify some of the ���ordinary��� encounters and interactions that midwives working in a hospital environment experience in their daily work and explore them from an ethical perspective. It found that many ethical decisions have to be made ���on-the-run���, with no time to contemplate or decide what the best course of action might be. As ethics is embedded within every encounter a midwife has, it is essential that all midwives have an awareness and understanding of their own value systems, professional ethical codes and ethical principles that can act as guides when they have to make choices in these situations, which are frequently challenging.

Does research into sensitive areas do harm? Experiences of research participation after a child���s diagnosis with Ewing���s Sarcoma

Objective: To investigate family members��� experiences of involvement in a previous study (conducted August 1995 to June 1997) following their child���s diagnosis with Ewing���s sarcoma. Design: Retrospective survey, conducted between 1 November and 30 November 1997, using a postal questionnaire. Participants: Eighty-one of 97 families who had previously completed an in-depth interview as part of a national case���control study of Ewing���s sarcoma. Main outcome measures: Participants��� views on how participation in the previous study had affected them and what motivated them to participate. Results: Most study participants indicated that taking part in the previous study had been a positive experience. Most (n = 79 [97.5%]) believed their involvement would benefit others and were glad to have participated, despite expecting and finding some parts of the interview to be painful. Parents whose child was still alive at the time of the interview recalled participation as more painful than those whose child had died before the interview. Parents who had completed the interview less than a year before our study recalled it as being more painful than those who had completed it more than a year before. Conclusions: That people suffering bereavement are generally eager to participate in research and may indeed find it a positive experience is useful information for members of ethics review boards and other ���gatekeepers���, who frequently need to determine whether studies into sensitive areas should be approved. Such information may also help members of the community to make an informed decision regarding participation in such research.

Social Participation of Community Dwelling Stroke Survivors [Published Abstract: From the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference 2009]

Disability following a stroke can impose various restrictions on patients��� attempts at participating in life roles. The measurement of social participation, for instance, is important in estimating recovery and assessing quality of care at the community level. Thus, the identification of factors influencing social participation is essential in developing effective measures for promoting the reintegration of stroke survivors into the community. Data were collected from 188 stroke survivors (mean age 71.7 years) 12 months after discharge from a stroke rehabilitation hospital. Of these survivors, 128 (61 %) had suffered a first ever stroke, and 81 (43 %) had a right hemisphere lesion. Most (n = 156, 83 %) were living in their own home, though 32 (17 %) were living in residential care facilities. Path analysis was used to test a hypothesized model of participation restriction which included the direct and indirect effects between social, psychological and physical outcomes and demographic variables. Participation restriction was the dependent variable. Exogenous independent variables were age, functional ability, living arrangement and gender. Endogenous independent variables were depressive symptoms, state self-esteem and social support satisfaction. The path coefficients showed functional ability having the largest direct effect on participation restriction. The results also showed that more depressive symptoms, low state self-esteem, female gender, older age and living in a residential care facility had a direct effect on participation restriction. The explanatory variables accounted for 71% of the variance in explaining participation restriction. Prediction models have empirical and practical applications such as suggesting important factors to be considered in promoting stroke recovery. The findings suggest that interventions offered over the course of rehabilitation should be aimed at improving functional ability and promoting psychological aspects of recovery. These are likely to enhance stroke survivors resume or maximize their social participation so that they may fulfill productive and positive life roles.

Cultivating teachers��� beliefs, knowledge and skills for leading change in schools

Australian policy initiatives and state curriculum reform efforts affirm a commitment to address student disengagement through the development of inclusive school environments, curriculum, and pedagogy. This paper, drawing on critical social theory, describes three Australian projects that support the cultivation of teachers��� beliefs, knowledge and skills for critical reflection and leading change in schools. The first project reports on the valued ethics that emerged in pre-service teacher reflections about a Service-learning Program at a university in Queensland. The second project reports on a school-based collaborative inquiry approach to professional development with a focus on literacy practices. The final project reports on an initiative in another university in Victoria, to operationalise pedagogical change and curriculum renewal in Victoria, through the Principles of Learning and Teaching (PoLT). These case studies illustrate how critical reflection and development of beliefs, knowledge and skills can be acquired to better meet the needs of schools.

Building climate change resilience and adaptive capacity in Australia���s community sector using social media and technology innovation

Public and private sector organisations worldwide are putting strategies in place to manage the commercial and operational risks of climate change. However, community organisations are lagging behind in their understanding and preparedness, despite them being among the most exposed to the effects of climate change impacts and regulation. This poster presents a proposal for a multidisciplinary study that addresses this issue by developing, testing and applying a novel climate risk assessment methodology that is tailored to the needs of Australia���s community sector and its clients. Strategies to mitigate risks and build resilience and adaptive capacity will be identified including new opportunities afforded by urban informatics, social media, and technologies of scale making.

Anxiety among high school students in India : comparisons across gender, school type, social strata, and perceptions of quality time with parents

The broad objective of the study was to better understand anxiety among adolescents in Kolkata city, India. Specifically, the study compared anxiety across gender, school type, socio-economic background and mothers��� employment status. The study also examined adolescents��� perceptions of quality time with their parents. A group of 460 adolescents (220 boys and 240 girls), aged 13-17 years were recruited to participate in the study via a multi-stage sampling technique. The data were collected using a self-report semi-structured questionnaire and a standardized psychological test, the State-Trait Anxiety Inventory. Results show that anxiety was prevalent in the sample with 20.1% of boys and 17.9% of girls found to be suffering from high anxiety. More boys were anxious than girls (p<0.01). Adolescents from Bengali medium schools were more anxious than adolescents from English medium schools (p<0.01). Adolescents belonging to the middle class (middle socio-economic group) suffered more anxiety than those from both high and low socio-economic groups (p<0.01). Adolescents with working mothers were found to be more anxious (p<0.01). Results also show that a substantial proportion of the adolescents perceived they did not receive quality time from fathers (32.1%) and mothers (21.3%). A large number of them also did not feel comfortable to share their personal issues with their parents (60.0% for fathers and 40.0% for mothers).

Finding Australia's social enterprise sector : final report

The forms social enterprises can take and the industries they operate in are so many and various that it has always been a challenge to define, find and count social enterprises. In 2009 Social Traders partnered with the Australian Centre for Philanthropy and Nonprofit Studies (ACPNS) at Queensland University of Technology to define social enterprise and, for the first time in Australia, to identify and map the social enterprise sector: its scope, its variety of forms, its reasons for trading, its financial dimensions, and the individuals and communities social enterprises aim to benefit.

The relationship between culture, attitude, social networks and quality of life in midlife Australian and Taiwanese citizens

Objectives: The objectives of this study were to specifically investigate the differences in culture, attitudes and social networks between Australian and Taiwanese men and women and identify the factors that predict midlife men and women���s quality of life in both countries. Methods: A stratified random sample strategy based on probability proportional sampling (PPS) was conducted to investigate 278 Australian and 398 Taiwanese midlife men and women���s quality of life. Multiple regression modelling and classification and regression trees (CARTs) were performed to examine the potential differences on culture, attitude, social networks, social demographic factors and religion/spirituality in midlife men and women���s quality of life in both Australia and Taiwan. Results: The results of this study suggest that culture involves multiple functions and interacts with attitudes, social networks and individual factors to influence a person���s quality of life. Significant relationships were found between the interaction between cultural circumstances and a person���s internal and external factors. The research found that good social support networks and a healthy optimistic disposition may significantly enhance midlife men and women���s quality of life. Conclusion: The study indicated that there is a significant relationship between culture, attitude, social networks and quality of life in midlife Australian and Taiwanese men and women. People who had higher levels of horizontal individualism and collectivism, positive attitudes and better social support had better psychological, social, physical and environmental health, while it emerged that vertical individualists with competitive characteristics would experience a lower quality of life. This study has highlighted areas where opportunities exist to further reflect upon contemporary social health policies for Australian and Taiwanese societies and also within the global perspective, in order to provide enhanced quality care for growing midlife populations.

Health law : scope, sources and forces

��� For the purposes of this chapter, ���health law��� encapsulates regulation of the medical and health professions, the administration of health services and the maintenance of public health to the extent that it is connected to the provision of health services. ��� There are diverging views as to whether health law can be regarded as a discrete ���area of law���. ��� Health law draws on other areas of law such as tort law, criminal law and family law. It is also draws upon other disciplines, most notably medical and health ethics. ��� Social and economic forces have influenced the development and direction of health law, and these forces may become even more influential as the century develops. ��� The increasingly globalised world has implications for Australia���s health systems and raises questions and creates commitments in respect of the international community. ��� Technological developments, including in respect of treatment, diagnosis and information management, create ongoing challenges for health law. ��� Patient rights, human rights and consumerism are increasingly key drivers in the development of health law. ��� Health law is significant to contemporary Australian society because of the gravity of the topics that fall within its ambit, its social relevance to so many aspects of human existence and endeavour, the important role it plays in protecting the vulnerable, and the extent to which it engages with fundamental principles of justice.

Standardization and omics science : technical and social dimensions are inseparable and demand symmetrical study

Standardization is critical to scientists and regulators to ensure the quality and interoperability of research processes, as well as the safety and efficacy of the attendant research products. This is perhaps most evident in the case of ���omics science,��� which is enabled by a host of diverse high-throughput technologies such as genomics, proteomics, and metabolomics. But standards are of interest to (and shaped by) others far beyond the immediate realm of individual scientists, laboratories, scientific consortia, or governments that develop, apply, and regulate them. Indeed, scientific standards have consequences for the social, ethical, and legal environment in which innovative technologies are regulated, and thereby command the attention of policy makers and citizens. This article argues that standardization of omics science is both technical and social. A critical synthesis of the social science literature indicates that: (1) standardization requires a degree of flexibility to be practical at the level of scientific practice in disparate sites; (2) the manner in which standards are created, and by whom, will impact their perceived legitimacy and therefore their potential to be used; and (3) the process of standardization itself is important to establishing the legitimacy of an area of scientific research.

An exploratory study of online social networking within a Doctorate of Education program

The professional doctorate is a degree that is specifically designed for professionals investigating real-world problems and relevant issues for a profession, industry and/or the community. The exploratory study on which this paper is based sought to track the scholarly skill development of a cohort of professional doctoral students who commenced their course in January 2008 at an Australian university. Via an initial survey and two focus groups held six months apart, the study aimed to determine if there had been any qualitative shifts in students��� understandings, expectations and perceptions regarding their developing knowledge and skills. Three key findings that emerged from this study were: (i) the appropriateness of using a blended learning approach in this professional doctoral program; (ii) the challenges of using wikis as an online technology for creating communities of practice; and (iii) the transition from professional to scholar is a process that requires the guided support inherent in the design of this particular doctorate of education program.

Predicting adolescents��� use of social networking sites from an extended theory of planned behaviour perspective

The popularity of social networking sites (SNSs) among adolescents has grown exponentially, with little accompanying research to understand the influences on adolescent engagement with this technology. The current study tested the validity of an extended theory of planned behaviour model (TPB), incorporating the additions of group norm and self-esteem influences, to predict frequent SNS use. Adolescents (N = 160) completed measures assessing the standard TPB constructs of attitude, subjective norm, perceived behavioural control (PBC), and intention, as well as group norm and self-esteem. One week later, participants reported their SNS use during the previous week. Support was found for the standard TPB variables of attitude and PBC, as well as group norm, in predicting intentions to use SNS frequently, with intention, in turn, predicting behaviour. These findings provide an understanding of the factors influencing frequent engagement in what is emerging as a primary tool for adolescent socialisation.

Indigenous men's support groups and social and emotional wellbeing : a meta-synthesis of the evidence

Indigenous men���s support groups are designed to empower men to take greater control and responsibility for their health and wellbeing. They provide health education sessions, counselling, men���s health clinics, diversionary programs for men facing criminal charges, cultural activities, drug- and alcohol-free social events, and advocacy for resources. Despite there being ~100 such groups across Australia, there is a dearth of literature on their strategies and outcomes. This paper is based on participatory action research involving two north Queensland groups which were the subject of a series of five ���phased��� evaluative reports between 2002 and 2007. By applying ���meta-ethnography��� to the five studies, we identified four themes which provide new interpretations of the data. Self-reported benefits included improved social and emotional wellbeing, modest lifestyle modifications and willingness to change current notions of ���gendered��� roles within the home, such as sharing housework. Our qualitative research to date suggests that through promoting empowerment, wellbeing and social cohesion for men and their families, men���s support groups may be saving costs through reduced expenditure on health care, welfare, and criminal justice costs, and higher earnings. Future research needs to demonstrate this empirically.