Paving pathways : shaping the public health workforce through tertiary education

Public health educational pathways in Australia have traditionally been the province of Universities, with the Master of Public Health (MPH) recognised as the flagship professional entry program. Public health education also occurs within the fellowship training of the Faculty of Public Health Medicine, but within Australia this remains confined to medical graduates. In recent years, however, we have seen a proliferation of undergraduate degrees as well as an increasing public health presence in the Vocational Education and Training (VET) sector. Following the 2007 Australian Federal election, the new Labour government brought with it a refreshing commitment to a more inclusive and strategic style of government. An important example of this was the 2020 visioning process that identified key issues of public health concern, including an acknowledgment that it was unacceptable to allocate less than 2% of the health budget towards disease prevention. This led to the recommendation for the establishment of a national preventive health agency (Australia: the healthiest country by 2020 National Preventative Health Strategy, Prepared by the Preventative Health Taskforce 2009). The focus on disease prevention places a spotlight on the workforce that will be required to deliver the new investment in health prevention, and also on the role of public health education in developing and upskilling the workforce. It is therefore timely to reflect on trends, challenges and opportunities from a tertiary sector perspective. Is it more desirable to focus education efforts on selected lead issues such as the “obesity epidemic”, climate change, Indigenous health and so on, or on the underlying theory and skills that build a flexible workforce capable of responding to a range of health challenges? Or should we aspire to both? This paper presents some of the key discussion points from 2008 - 2009 of the Public Health Educational Pathways workshops and working group of the Australian Network of Public Health Institutions. We highlight some of the competing tensions in public health tertiary education, their impact on public health training programs, and the educational pathways that are needed to grow, shape and prepare the public health workforce for future

Growth restriction before and after birth increases kinase signaling pathways in the adult rat heart

To investigate the mechanisms for the previously reported development of adult cardiac hypertrophy in male rats following growth restriction, the levels of oxidative stress and activation of signaling kinases were measured in the left ventricle (LV) of adult rat offspring. In experiment one, bilateral uterine vessel ligation to induce uteroplacental insufficiency and growth restriction in the offspring (Restricted) or sham surgery was performed during pregnancy. Litters from sham mothers had litter size either reduced (Reduced Litter), which also restricted postnatal growth, or were left unaltered (Control). In males, Reduced Litter offspring had increased LV phosphorylation of AMPKa, p38 MAPK and Akt compared with Restricted and Controls (P,0.05). In females, both Restricted and Reduced Litter adult offspring had increased LV phosphorylation of p38 MAPK and Akt, however, only Restricted offspring had increased phosphorylation of AMPKa (P,0.05). In addition, only Restricted male offspring displayed LV oxidative stress (P,0.05). Experiment two investigated in mothers exposed to uteroplacental insufficiency or sham surgery the effects of cross-fostering offspring at birth, and therefore the effects of the postnatal lactational environment. Surprisingly, the cross-fostering itself resulted in increased LV phosphorylation of AMPKa and Akt in females and increased phosphorylation of Akt in males compared with Control non-cross-fostered offspring (P,0.05). In conclusion, kinase signaling in the adult LV can be programmed by uteroplacental insufficiency induced growth restriction in a gender-specific manner. In addition, the heart of adult rats is also sensitive to programming following the postnatal intervention of cross-fostering alone as well as by postnatal growth restriction.

Oxidative pathways as a drug target for the treatment of autism

Importance of the field: Autism is a severe, pervasive developmental disorder, the aetiology of which is poorly understood. Current pharmacological treatment options for autism are often focused on addressing comorbid behavioural problems, rather than core features of the disorder. Investigation of a new treatment approach is needed.

Areas covered in this review: Recent research has indicated a possible role of abnormalities in oxidative homeostasis in the pathophysiology of autism, based on reports that a range of oxidative biomarkers are significantly altered in people with autism. This article reviews the current findings on oxidative stress in autism, including genetic links to oxidative pathways, changes in antioxidant levels and other oxidative stress markers. We conducted a search of the literature up to June 2010, using Medline, Pubmed, PsycINFO, CINAHL PLUS and BIOSIS Previews.

What the reader will gain: This review provides an overview of the current understanding of the role of oxidative stress in autism. This will assist in highlighting areas of future therapeutic targets and potential underlying pathophysiology of this disorder.

Take home message: Abnormalities in oxidative homeostasis may play a role in the pathophysiology of autism. Antioxidant treatment may form a potential therapeutic pathway for this complex disorder.

Pathways to industry : work practices of undergraduate students in construction programs in Australia

This research reports the impact of work on undergraduate students enrolled in construction programs. Students responded to a questionnaire on the nature of their paid work while enrolled in full-time study in six universities across Australia. The results indicate that students are working on average 19 hours per week during semester time. The results indicate that students in the early years tend to undertake casual work that is not related to their degree. However, this pattern changes in the later years of the program, where students switch to roles in construction that does relate to their coursework. The students start working on average 16 hours in the first year of their degree, and the number rises to 24 hours in their final year. Past research suggests that students may be working to an extent beyond what is considered beneficial to their studies. Past research has shown that working long hours has a negative effect on the study patterns of undergraduate students. The implications of the amount of time working and the type of work are discussed. The paper concludes by suggesting that universities need a greater awareness of the impact of paid employment on student engagement.

Problematic placement : pathways pre-service teachers’ perspectives on their infant/toddler placement

The inclusion of an infant/toddler placement in a ‘pathways’ early childhood teaching degree, where students already have qualifications and experience in working with young children, can be problematic. This pilot study investigated student teachers’ views on their infant/toddler (birth-to-two-years) placement. Sixty-six students completing their early childhood education degree at an Australian university responded to a survey seeking their perspectives on the effectiveness of the placement in developing teacher confidence, knowledge and skills, and the quality of the supervision they received. The participants had entered their degree with a two-year Diploma of Children’s Services. Responses indicated significant dissatisfaction with the quality of supervision, the absence of teacher-mentors, and the lack of opportunities to practise new approaches. Participants commented that they ‘already knew’ how to work with this age group, and that they aspired to work with older children. The results align with other findings on factors associated with positive placements, and raise questions about the effectiveness of the infant/toddler placement in its current form.

Alternative pathways to traditional destinations : higher education for disadvantaged Australians

In 1985, the Higher Education Equity Program was introduced by the Australian Government to improve the participation of those persons from social groups traditionally under-represented within higher education. In 1990, the program was incorporated within A Fair Chance For All which provided more specific details of the government's desire for a system-wide approach to equity issues. One result has been the proliferation of access and equity programs conducted by universities around the country and aimed at redressing the disadvantage of potential students. The alleged success of these programs is based on greater participation in and graduation from Australian universities by individuals from targeted disadvantaged groups. The research reported here, however, would suggest that such programs are prone to co-opt the language of equity and social justice, dependent as they are on satisfying statistically-orientated program performance indicators in order to receive recurrent government funding. Further, the paper argues that success in achieving equity within Australian higher education will remain limited unless the structural arrangements that work to construct social inequalities in mainstream higher education are addressed.

Achieving diversity : pathways may be the solution!

This paper examines the role of pathways in increasing the diversity of higher education student cohorts. The Commonwealth Government has as its higher education reform agenda the increased participation of under-represented groups to a 20% diversity target for Australian universities. Yet for many universities, reaching this target will require significant changes to entry and access conditions. This paper examines two case studies of construction education pathways and evaluates their effectiveness in addressing diversity using the DEMO matrix developed by the National Centre for Student Equity in Higher Education (NCSEHE). The first case study was based on a VET in Schools model that articulates school students into construction courses in TAFE and higher education. The second case study targets mature aged people who do not have formal qualifications in construction, but wish to participate in higher education. The results indicate that pathways into construction degrees can improve student equity ratios, but element such as learner engagement, confidence, resources and collaboration are critical features of successful pathways. These results have important implications for future decision making regarding university articulation models in light of higher education diversity targets.

Pathways to formally assessed work placement : employers' perspectives on collaborative education in the Australian construction industry

The QS and construction industry is uniquely impacted by project-based work environments. This creates special challenges for collaborative, work-integrated education of pre-professional students. This research is based on investigating the attitudes of employer’s towards the use of formally assessed internships. The study comprised two stages- firstly a series of pilot interviews were undertaken with employers to test a number known issues and secondly, the results from the interviews were used to refine a set of questions that were put to a large focus group of employers who were invited from across the property and construction sector in Australia. The results showed that many employer organisations expressed considerable goodwill towards collaborative education with universities. However, the challenges caused by project-based work environments restrict employers' ability to provide comprehensive learning opportunities. This research discusses some of the distinctive issues associated with work-integrated learning in the construction industry and proposes some potential opportunities for overcoming these restrictions.

Descending pathways from the paraventricular nucleus contribute to the recruitment of brainstem nuclei following a systemic immune challenge

Hypothalamic nuclei, particularly the paraventricular nuclei (PVN), are important brain sites responsible for central nervous system responses during an immune challenge. The brainstem catecholamine cells of the nucleus tractus solitarius (NTS) and ventrolateral medulla (VLM) have been shown to play critical roles in relaying systemic immune signals to the PVN. However, whilst it is well recognised that PVN divisions also innervate the NTS and VLM, it is not known whether descending PVN pathways can modulate the recruitment of brainstem cells during an immune challenge. Using systemic administration of the proinflammatory cytokine interleukin-1β, in combination with Fos immunolabelling, we firstly investigated the effect of PVN lesions on NTS and VLM catecholamine and non-catecholamine cell responses. We found that ibotenic acid lesions of the PVN significantly reduced numbers of Fos-positive non-catecholamine, noradrenergic and adrenergic cells observable in the VLM and NTS after interleukin-1β administration. We then investigated the origins of descending inputs to the VLM and NTS, activated by systemic interleukin-1β, by mapping the distribution of Fos-positive retrogradely-labelled cells in divisions of the PVN after iontophoretically depositing choleratoxin-b subunit into the NTS or VLM one week prior to interleukin-1β administration. We found that, after either NTS or VLM deposits, the majority of retrogradely-labelled Fos-positive cells activated by interleukin-1β were localised in the medial and lateral parvocellular PVN divisions. Retrogradely-labelled Fos-positive cells were also observed in the NTS after VLM deposits, and in the VLM after NTS tracer deposits, suggesting reciprocal communication between these two nuclei after systemic interleukin-1β. Thus the present study shows that the PVN has the capacity to modulate NTS and VLM responses after an immune challenge and that these may result from descending projections arising in the medial and lateral PVN divisions. These findings suggest that central nervous system responses to an immune challenge are likely to involve complex reciprocal connections between the PVN and the brainstem as well as between brainstem nuclei themselves.