Livable housing design: Is it likely to work?

The need for accessible housing in Australia is acute. Both government and the community service sector recognise the importance of well designed accessible housing to optimise the integration of older people and people with disability, to encourage a prudent use of scarce health and community services and to enhance the liveability of our cities. In 2010, the housing industry, negotiated with the Australian Government and community representatives to adopt a nationally consistent voluntary code (Livable Housing Design) and a strategy to provide minimal level of accessibility in all new housing by 2020. Evidence from the implementation of such programs in the United Kingdom and USA, however, serves to question whether this aspirational goal can be achieved through voluntary codes. Minimal demand at the point of new sale, and problems in the production of housing to the required standards have raised questions regarding the application of program principles in the context of a voluntary code. In addressing the latter issue, this paper presents early findings from the analysis of qualitative interviews conducted with developers, builders and designers in various housing contexts. It identifies their “logics in use” in the production of housing in response to Livable Housing Design’s voluntary code and indicates factors that are likely to assist and impede the attainment of the 2020 aspirational goal.

Cyberbullying : a threat to student mental health and wellbeing

Cyberbullying is a threat to student mental health and wellbeing. As predicted the consequences of cyberbullying have been shown to be more detrimental to students than traditional bullying because of the wider audience and the 24/7 nature of this form of bullying. It is becoming an increasingly vexatious problem for victims, students who bully, educators and parents. Parents and the community are turning to schools to provide preventative strategies and to manage incidents of cyberbullying. Some sections of the community believe there is a technological solution to the problem, or that the law should be overhauled to address the problem more effectively. However, bullying is a deeply embedded social relationship problem, of which cyberbullying is one form. Therefore, planned prevention and intervention strategies need to be considered in the context of the social relationships in the whole school community.

The oral health of critically ill children : an observational cohort study

Aims and objectives: This study will describe the oral health status of critically ill children over time spent in the paediatric intensive care unit, examine influences on the development of poor oral health and explore the relationship between dysfunctional oral health and healthcare-associated infections. Background: The treatment modalities used to support children experiencing critical illness and the progression of critical illness may result in dysfunction in the oral cavity. In adults, oral health has been shown to worsen during critical illness as well as influence systemic health. Design: A prospective observational cohort design was used. Method: The study was undertaken at a single tertiary-referral Paediatric Intensive Care Unit. Oral health status was measured using the Oral Assessment Scale and culturing oropharyngeal flora. Information was also collected surrounding the use of supportive therapies, clinical characteristics of the children and the occurrence of healthcare-associated infections. Results: Of the 46 participants, 63% (n = 32) had oral dysfunction and 41% (n = 19) demonstrated pathogenic oropharyngeal colonisation during their critical illness. The potential systemic pathogens isolated from the oropharynx and included Candida sp., Staphylococcus aureus, Haemophilus influenzae, Enterococcus sp. and Pseudomonas aeruginosa. The severity of critical illness had a significant positive relationship (p < 0·05) with pathogenic and absent colonisation of the oropharynx. Sixty-three percent of healthcare-associated infections involved the preceding or simultaneous colonisation of the oropharynx by the causative pathogen. Conclusions: This study suggests paediatric oral health to be frequently dysfunctional and the oropharynx to repeatedly harbour potential systemic pathogens during childhood critical illness. Relevance to clinical practice: Given the frequency of poor oral health during childhood critical illness in this study and the subsequent potential systemic consequences, evidence based oral hygiene practices should be developed and validated to guide clinicians when nursing critically ill children.

Knowledge to deal with challenges to science education from without and within

This chapter focuses on two challenges to science teachers’ knowledge that Fensham identifies as having recently emerged—one a challenge from beyond Science and the other a challenge from within Science. Both challenges stem from common features of contemporary society, namely, its complexity and uncertainty. Both also confront science teachers with teaching situations that contrast markedly with the simplicity and certainty that have been characteristic of most school science education, and hence both present new demands for science teachers’ knowledge and skill. The first, the challenge from without Science, comes from the new world of work and the “knowledge society”. Regardless of their success in traditional school learning, many young persons in many modern economies are now seen as lacking other knowledge and skills that are essential for their personal, social and economic life. The second, the challenge from within Science, derives from changing notions of the nature of science itself. If the complexity and uncertainty of the knowledge society demand new understandings and contributions from science teachers, these are certainly matched by the demands that are posed by the role of complexity and uncertainty in science itself.

Ocular characteristics of anisometropia

Animal models of refractive error development have demonstrated that visual experience influences ocular growth. In a variety of species, axial anisometropia (i.e. a difference in the length of the two eyes) can be induced through unilateral occlusion, image degradation or optical manipulation. In humans, anisometropia may occur in isolation or in association with amblyopia, strabismus or unilateral pathology. Non-amblyopic myopic anisometropia represents an interesting anomaly of ocular growth, since the two eyes within one visual system have grown to different endpoints. These experiments have investigated a range of biometric, optical and mechanical properties of anisometropic eyes (with and without amblyopia) with the aim of improving our current understanding of asymmetric refractive error development. In the first experiment, the interocular symmetry in 34 non-amblyopic myopic anisometropes (31 Asian, 3 Caucasian) was examined during relaxed accommodation. A high degree of symmetry was observed between the fellow eyes for a range of optical, biometric and biomechanical measurements. When the magnitude of anisometropia exceeded 1.75 D, the more myopic eye was almost always the sighting dominant eye. Further analysis of the optical and biometric properties of the dominant and non-dominant eyes was conducted to determine any related factors but no significant interocular differences were observed with respect to best-corrected visual acuity, corneal or total ocular aberrations during relaxed accommodation. Given the high degree of symmetry observed between the fellow eyes during distance viewing in the first experiment and the strong association previously reported between near work and myopia development, the aim of the second experiment was to investigate the symmetry between the fellow eyes of the same 34 myopic anisometropes following a period of near work. Symmetrical changes in corneal and total ocular aberrations were observed following a short reading task (10 minutes, 2.5 D accommodation demand) which was attributed to the high degree of interocular symmetry for measures of anterior eye morphology, and corneal biomechanics. These changes were related to eyelid shape and position during downward gaze, but gave no clear indication of factors associated with near work that might cause asymmetric eye growth within an individual. Since the influence of near work on eye growth is likely to be most obvious during, rather than following near tasks, in the third experiment the interocular symmetry of the optical and biometric changes was examined during accommodation for 11 myopic anisometropes. The changes in anterior eye biometrics associated with accommodation were again similar between the eyes, resulting in symmetrical changes in the optical characteristics. However, the more myopic eyes exhibited slightly greater amounts of axial elongation during accommodation which may be related to the force exerted by the ciliary muscle. This small asymmetry in axial elongation we observed between the eyes may be due to interocular differences in posterior eye structure, given that the accommodative response was equal between eyes. Using ocular coherence tomography a reduced average choroidal thickness was observed in the more myopic eyes compared to the less myopic eyes of these subjects. The interocular difference in choroidal thickness was correlated with the magnitude of spherical equivalent and axial anisometropia. The symmetry in optics and biometrics between fellow eyes which have undergone significantly different visual development (i.e. anisometropic subjects with amblyopia) is also of interest with respect to refractive error development. In the final experiment the influence of altered visual experience upon corneal and ocular higher-order aberrations was investigated in 21 amblyopic subjects (8 refractive, 11 strabismic and 2 form deprivation). Significant differences in aberrations were observed between the fellow eyes, which varied according to the type of amblyopia. Refractive amblyopes displayed significantly higher levels of 4th order corneal aberrations (spherical aberration and secondary astigmatism) in the amblyopic eye compared to the fellow non-amblyopic eye. Strabismic amblyopes exhibited significantly higher levels of trefoil, a third order aberration, in the amblyopic eye for both corneal and total ocular aberrations. The results of this experiment suggest that asymmetric visual experience during development is associated with asymmetries in higher-order aberrations, proportional to the magnitude of anisometropia and dependent upon the amblyogenic factor. This suggests a direct link between the development of higher-order optical characteristics of the human eye and visual feedback. The results from these experiments have shown that a high degree of symmetry exists between the fellow eyes of non-amblyopic myopic anisometropes for a range of biomechanical, biometric and optical parameters for different levels of accommodation and following near work. While a single specific optical or biomechanical factor that is consistently associated with asymmetric refractive error development has not been identified, the findings from these studies suggest that further research into the association between ocular dominance, choroidal thickness and higher-order aberrations with anisometropia may improve our understanding of refractive error development.

Self-Government and the fashioning of resilient personae : legal education, criminal justice, and the government of mental health

This paper explores attempts to shape resilient personae through relations of self-government, and highlights the way that this features as part of advanced liberal forms of rule. As an example of this process, it focuses on the way that undergraduate law students are encouraged to fashion resilient personae throughout their legal studies, so as to avoid, or effectively respond to, experiences that may have a detrimental effect on their mental health. This paper argues that the production of such resilience relies on students being encouraged to take up psychologically- and biomedically-infused subject positions, becoming well-disciplined subjects, entrepreneurs of the self, and even virtuous persons. It highlights that the fashioning of resilient personae in this way involves extensions to the targets and practices of self-government and reinforces advanced liberal government. The paper then suggests how insights into fashioning resilience in this context can inform further research on resilience, particularly resilience produced within criminal justice professionals.

Contemporary public health policy

- identify the terms policy, public policy and health policy, the stages of policy development and the role that values and politics play in policymaking - recognise contemporary international developments in public health and their impact on national policymaking and the health of Australians - describe the basic structure and financing of Australia’s health system and the role of public health within it - identify Australia’s national public health priorities, and be able to critique the development of the National Chronic Disease Strategy, as an example.

Ethics and public health

• recognise that “ethics” is often defined and approached in different ways • describe the foundations and development of public health ethics • summarise some key ethical systems and their relevance to public health practice • outline and critique some codes of ethics, and discuss their application to public health practice • recognise, evaluate and communicate ethical concerns regarding public health, and apply ethical principles in your practice.

Social and emotional determinants of health

- describe what is meant by socioeconomic differences in health, and the social and emotional determinants of health - understand how health inequalities are affected by the social and economic circumstances that people experience throughout their lives - discuss how factors such as living and working conditions, income, place and education can impact on health - identify actions for public health policy-makers that have the potential to make a difference in improving health outcomes within populations - appreciate the concept of social cohesion and social capital, and their role as potential protective factors in health - understand conceptual models that can assist in analysing these issues.

Health promotion

The ‘promotion of health’ has become everybody’s business: from the marketers of ‘healthy’ products and lifestyles, and gym memberships; government media campaigns to ‘Go for 2&5®’ (fruit and vegetables every day), special ‘extra’ benefits for joining a private health insurance fund and workplace ‘wellness’ programs that include yoga and pilates. For consumers, the list is endless. Health professionals need to understand the background to this growth in the promotion of ‘health’ and the place health promotion plays in public health. We begin this chapter with a discussion on health education, we then trace the evolution of health promotion from health education, the strategies and settings for health promotion, and conclude with challenges for health promotion. Case studies, activities and reflections on the material are presented to assist you.

Defining health and public health

- define health and public health - discuss how the concept of ‘health’ means different things to different individuals and be able to consider the range of factors that influence these definitions - identify and describe the principles of public health - recognise and describe how public health is defined and how each definition has shaped the development and implementation of public health approaches - describe the relationship between public health and other disciplines - discuss the nature and scope of public health - describe the varying roles of the public health workforce

History and development of public health

- briefly describe the importance of public health history to contemporary public health - briefly describe the ancient history of public health - outline the key periods and activities in the modern history of Western public health - describe and understand the important roles of political, social, environmental and economic factors as they impact on health - consider the major factors that have influenced an understanding of contemporary public health in the past 40 years.