Geekdom for Grrrls health : Australian undergraduate experiences developing and promoting women’s health in cyberspace

There is an increasing global reliance on the Internet for retrieving information on health, illness, and recovery (Sillence et al, 2007; Laurent et al, 2009; Adams, 2010). People suffering from a vast array of illnesses, conditions, and complaints, as well as healthy travelers seeking advice about safe practices abroad, and teens seeking information about safe sexual practices are all now more likely to go to the internet for information than they are to rely solely on a general practitioner or physician (Santor et al, 2007; Moreno et al, 2009; Bartlett et al, 2010). Women in particular seek advice and support online for a number of health-related concerns regarding issues such as puberty, conception, pregnancy, postnatal depression, mothering, breast-cancer recovery, and ageing healthily (van Zutphen, 2008; Raymond et al, 2005). In keeping with this increasing socio-technological trend, the Women’s Health Unit at the Queensland University of Technology (Q.U.T), Brisbane, Australia, introduced the research, design, and development of online information resources for issues affecting the health of Australian women as an assessment item for students in the undergraduate Public Health curriculum. Students were required to research a particular health issue affecting Australian women, including pregnancy, pregnancy terminations, postnatal depression, returning to the work force after having a baby, breast cancer recovery, chronic disease prevention, health and safety for sex-workers, and ageing healthily. Students were required to design and develop websites that supported people living with these conditions, or who were in these situations. The websites were designed for communicating effectively with both women seeking information about their health, and their health practitioners. The pedagogical challenge inherent in this exercise was twofold: firstly, to encourage students to develop the skills to design and maintain software for online health forums; and secondly, to challenge public health students to go beyond generating ‘awareness’ and imparting health information to developing a nuanced understanding of the worlds and perspectives of their audiences, who require supportive networks and options that resonate with their restrictions, capabilities, and dispositions. This latter challenge spanned the realms of research, communication, and aesthetic design. This paper firstly, discusses an increasing reliance on the Internet by women seeking health-related information and the potential health risks and benefits of this trend. Secondly, it applies a post-structural analysis of the de-centred and mobile female self, as online social ‘spaces’ and networks supersede geographical ‘places’ and hierarchies, with implications for democracy, equality, power, and ultimately women’s health. Thirdly, it depicts the processes (learning reflections) and products (developed websites) created within this Women’s Health Unit by the students. Finally, we review this development in the undergraduate curriculum in terms of the importance of providing students with skills in research, communication, and technology in order to share and implement improved health care and social marketing for women as both recipients and providers of health care in the Internet Age.

Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes

Socio-economic gradients in cardiovascular disease (CVD) and diabetes have been found throughout the developed world and there is some evidence to suggest that these gradients may be steeper for women. Research on social gradients in biological risk factors for CVD and diabetes has received less attention and we do not know the extent to which gradients in biomarkers vary for men and women. We examined the associations between two indicators of socio-economic position (education and household income) and biomarkers of diabetes and cardiovascular disease (CVD) for men and women in a national, population-based study of 11,247 Australian adults. Multi-level linear regression was used to assess associations between education and income and glucose tolerance, dyslipidaemia, blood pressure (BP) and waist circumference before and after adjustment for behaviours (diet, smoking, physical activity, TV viewing time, and alcohol use). Measures of glucose tolerance included fasting plasma glucose and insulin and the results of a glucose tolerance test (2 h glucose) with higher levels of each indicating poorer glucose tolerance. Triglycerides and High Density Lipoprotein (HDL) Cholesterol were used as measures of dyslipidaemia with higher levels of the former and lower levels of the later being associated with CVD risk. Lower education and low income were associated with higher levels of fasting insulin, triglycerides and waist circumference in women. Women with low education had higher systolic and diastolic BP and low income women had higher 2 h glucose and lower HDL cholesterol. With only one exception (low income and systolic BP), all of these estimates were reduced by more than 20% when behavioural risk factors were included. Men with lower education had higher fasting plasma glucose, 2 h glucose, waist circumference and systolic BP and, with the exception of waist circumference, all of these estimates were reduced when health behaviours were included in the models. While low income was associated with higher levels of 2-h glucose and triglycerides it was also associated with better biomarker profiles including lower insulin, waist circumference and diastolic BP. We conclude that low socio-economic position is more consistently associated with a worse profile of biomarkers for CVD and diabetes for women.

The Supervisory Relationship

The nature of the relationship that is negotiated, developed and maintained between a clinical supervisor and supervisee is central to effectively engage in clinical work, to promote professional and personal development, and to ensure consistent ethical practice. In this chapter attention is given to the challenges, importance and benefits of the supervisory relationship. The ability to form and sustain relationships in supervision and in clinical practice is more crucial than specific knowledge and therapeutic skills (Dye, 2004). Attention to parallel process, the working alliance, multiple roles, expectations and acculturative issues are addressed. This is an introduction to some of the most salient issues concerning the supervisory relationship and is a review of concepts and processes discussed in greater depth throughout this textbook. The reader is encouraged to utilise the references and suggested readings to deepen their understanding of the supervisory relationship.

The emotional geography of a mine closure: a study of the Ravensthorpe nickel mine in Western Australia

This paper engages with the literature on emotional geographies to report on a case study of the emotions surrounding the closure of a nickel mine in the shire of Ravensthorpe in the south-west of Western Australia in January 2009. Two themes from the affect-infused narratives of pre- and post-mine community members are outlined. The first, which challenges constructions of the closure as a purely industrial and economic concern, focuses on the intense feelings the shut-down invoked amongst participants. The second theme explores the way in which the owner of the mine, BHP Billiton, worked to suppress and regulate affective reactions to the closure and thus reveals the highly political nature of emotions.

Should cooking be a dietetic competency?

Aim:  There are issues surrounding the apparent decline and devaluing of cooking skills in the population, potential health impacts and the role of dietitians. The present paper aims to outline several arguments and raise questions on the relationship between cooking and dietetics.---------- Methods:  Evidence from dietetics and nutrition journals and other sources is used to develop positions for dietetics and its relationship to cooking and cooking skills. ---------- Results:  The historical relationship between dietetics and home economics has seen dietetics professionally distance itself by its scientific education on food and nutrition, rather than actual involvement with cooking. In pursuing this rational scientific approach there are concerns that dietitians have inadvertently supported the growth of the functional and convenience food market, particularly given the demise of home economics as a skill-based curricula in schools in several states. There is a need to consider what role cooking skills could have in dietetics training as a professional competency for practice, particularly for public health interventions. This is in the light of Commonwealth government funding that is legitimising cooking skill interventions as a policy response to obesity. There may be a role for dietitians to develop partnerships and train a new professional category or paraprofessionals and/or peer educators to deliver cooking skill interventions. ---------- Conclusion:  There is a need for research on dietitian's views and use of cooking skill interventions. This would help answer whether we should consider cooking and cooking skills as part of our professional practice and whether cooking should be a dietetic competency.

What's cooking for dietetics? A review of the literature

Aim: There has been no systematic research on the role of cooking skills for improving dietary intakes in Australia. Cooking skills are proposed to be declining and/or being devalued. If cooking skills have been devalued and declining, then what evidence is there for this decline and what impact might this have on dietary intakes? The aim of the present paper is to explore these assumptions with particular reference to Australia. The objectives of the present paper are to define the terms cooking and cooking skills, discuss evidence on levels of cooking skills in Australia and describe the evidence linking cooking skills to dietary intakes.---------- Methods: A review of the peer-reviewed literature using multiple databases from 1990 to September 2009.---------- Results: Cooking skills are complex and require a range of processes for people to develop efficiency or confidence in food preparation. There is little evidence on the level of cooking skills in the Australian population and how this relates to dietary intakes. The Australian Bureau of Statistic’s latest Time Use Survey and Household Expenditure Survey suggest that cooking is still a gendered activity and that the time devoted to cooking has changed little in the past 15 years, but there is an increasing use of foods prepared outside the home.---------- Conclusion: Further research is required to examine the prevalence of different types and levels of cooking skills in Australia as well as their potential effects on dietary intakes. Dietitians need evidence about the level of cooking skills people require for healthy dietary intakes.

Food literacy : time for a new term or just another buzzword?

Eating is an essential everyday life activity that has fascinated, captivated and defined society since time began. We currently exist in a society where over-consumption of food is an established risk factor chronic disease, the rate of which is increasing alarmingly. 'Food literacy' is an emerging term used to describe what we, as individuals and as a community know and understand about food and how to use it to meet our need, and thus potentially support and empower citizens to make healthy food choices. What exactly the components of food literacy are and how they influence food choice are poorly defined and understood, but increasingly gaining interest among health professionals, policy makers, community workers, educators and members of the public. This paper will build the argument for why concepts of 'food literacy' need to extend beyond existing terms and measures used in the literature to describe the food skills and knowledge needed to make use of public health nutrition messages.

Adherence to fish oil intervention in patients with chronic kidney disease

Objective: With growing recognition of the role of inflammation in the development of chronic and acute disease, fish oil is increasingly used as a therapeutic agent, but the nature of the intervention may pose barriers to adherence in clinical populations. Our objective was to investigate the feasibility of using a fish oil supplement in hemodialysis patients. ---------- Design: This was a nonrandomized intervention study.---------- Setting: Eligible patients were recruited at the Hemodialysis Unit of Wesley Hospital, Brisbane, Queensland, Australia. Patients The sample included 28 maintenance hemodialysis patients out of 43 eligible patients in the unit. Exclusion criteria included patients regularly taking a fish oil supplement at baseline, receiving hemodialysis for less than 3 months, or being unable to give informed consent.---------- Intervention: Eicosapentaenoic acid (EPA) was administered at 2000 mg/day (4 capsules) for 12 weeks. Adherence was measured at baseline and weekly throughout the study according to changes in plasma EPA, and was further measured subjectively by self-report.---------- Results: Twenty patients (74%) adhered to the prescription based on changes in plasma EPA, whereas an additional two patients self-reported good adherence. There was a positive relationship between fish oil intake and change in plasma EPA. Most patients did not report problems with taking the fish oil. Using the baseline data, it was not possible to characterize adherent patients.---------- Conclusions: Despite potential barriers, including the need to take a large number of prescribed medications already, 74% of hemodialysis patients adhered to the intervention. This study demonstrated the feasibility of using fish oil in a clinical population.

Assessing wet crashes for the skid resistance management of road assets

Australia, road crash trauma costs the nation A$15 billion annually whilst the US estimates an economic impact of around US$ 230 billion on its network. Worldwide economic cost of road crashes is estimated to be around US$ 518 billion each year. Road accidents occur due to a number of factors including driver behaviour, geometric alignment, vehicle characteristics, environmental impacts, and the type and condition of the road surfacing. Skid resistance is considered one of the most important road surface characteristics because it has a direct effect on traffic safety. In 2005, Austroads (the Association of Australian and New Zealand Road Transport and Traffic Authorities) published a guideline for the management of skid resistance and Queensland Department of Main Roads (QDMR) developed a skid resistance management plan (SRMP). The current QDMR strategy is based on rationale analytical methodology supported by field inspection with related asset management decision tools. The Austroads’s guideline and QDMR's skid resistance management plan have prompted QDMR to review its skid resistance management practice. As a result, a joint research project involving QDMR, Queensland University of Technology (QUT) and the Corporative Research Centre for Integrated Engineering Asset Management (CRC CIEAM) was formed. The research project aims at investigating whether there is significant relationship between road crashes and skid resistance on Queensland’s road networks. If there is, the current skid resistance management practice of QDMR will be reviewed and appropriate skid resistance investigatory levels will be recommended. This paper presents analysis results in assessing the relationship between wet crashes and skid resistance on Queensland roads. Attributes considered in the analysis include surface types, annual average daily traffic (AADT), speed and seal age.

Diagnostic and treatment pathways for men with prostate cancer in Queensland : investigating spatial and demographic inequalities

Background: Patterns of diagnosis and management for men diagnosed with prostate cancer in Queensland, Australia, have not yet been systematically documented and so assumptions of equity are untested. This longitudinal study investigates the association between prostate cancer diagnostic and treatment outcomes and key area-level characteristics and individual-level demographic, clinical and psychosocial factors.---------- Methods/Design: A total of 1064 men diagnosed with prostate cancer between February 2005 and July 2007 were recruited through hospital-based urology outpatient clinics and private practices in the centres of Brisbane, Townsville and Mackay (82% of those referred). Additional clinical and diagnostic information for all 6609 men diagnosed with prostate cancer in Queensland during the study period was obtained via the population-based Queensland Cancer Registry. Respondent data are collected using telephone and self-administered questionnaires at pre-treatment and at 2 months, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months post-treatment. Assessments include demographics, medical history, patterns of care, disease and treatment characteristics together with outcomes associated with prostate cancer, as well as information about quality of life and psychological adjustment. Complementary detailed treatment information is abstracted from participants’ medical records held in hospitals and private treatment facilities and collated with health service utilisation data obtained from Medicare Australia. Information about the characteristics of geographical areas is being obtained from data custodians such as the Australian Bureau of Statistics. Geo-coding and spatial technology will be used to calculate road travel distances from patients’ residences to treatment centres. Analyses will be conducted using standard statistical methods along with multilevel regression models including individual and area-level components.---------- Conclusions: Information about the diagnostic and treatment patterns of men diagnosed with prostate cancer is crucial for rational planning and development of health delivery and supportive care services to ensure equitable access to health services, regardless of geographical location and individual characteristics. This study is a secondary outcome of the randomised controlled trial registered with the Australian New Zealand Clinical Trials Registry (ACTRN12607000233426)

Workers’ UV exposure and the subsequent impact on skin

Introduction: Excessive exposure to ultraviolet (UV) radiation from sunlight is a causative factor in the development of skin damage and skin cancer. Little research has been undertaken into assessing the sun exposure linking to skin damage inside buildings or behind window glass. This project directly addressed this issue by aiming to assess the role that UV exposure has on skin damage for indoor workers and drivers. Methods: Measurements of personal UV exposure using UV sensitive polymer dosimeters were undertaken of 41 indoor workers and 3 professional drivers. Physical measurements of skin characteristics including skin pigmentation and UV induced skin photoaging were also determined. In addition, demographic information along with phenotypic characteristics, sun exposure and sun protection practice history, and history of skin damage were assessed through a questionnaire. Results: Indoor workers typically received low doses of UV radiation. However, one driver received a high dose (13J/cm2 UVA and 4.99 MED UVB on the arm). Age and years residing in Australia had a positive correlation with UV induced skin pigmentation. The number of major sunburns before 18 years was a risk factor for skin damage in adults. Those participants with fair skin, non-black hair and blue/green /blue-grey eye were more likely to have skin damage related to sun exposure. Conclusions: A person’s age, years residing in Australia, numbers of major sunburn, skin colour, hair colour and eye colour are important factors associated with the development of sun-related skin damage in workers. ‘Real World’ implications: 1. The number of major sunburns before 18 years was a risk factor for skin damage in adults. This clearly confirms the importance of early prevention. To protect the skin from extensive sun exposure for your generation should have significance for further prevention of skin damage. 2. It is unsurprising that age and years residing in Australia were associated with skin damage related UV radiation. Therefore, the general public should reinforce their sun protective measures and check skin regularly. 3. Drivers should take sun protective measures during their working hours between sunrise and sunset.

A 'conceptual models' approach to organisational resilience

Gibson and Tarrant discuss the range of inter-dependant factors needed to manage organisational resilience. Over the last few years there has been considerable interest in the idea of resilience across all areas of society. Like any new area or field this has produced a vast array of definitions, processes, management systems and measurement tools which together have clouded the concept of resilience. Many of us have forgotten that ultimately resilience is not just about ‘bouncing back from adversity’ but is more broadly concerned with adaptive capacity and how we better understand and address uncertainty in our internal and external environments. The basis of organisational resilience is a fundamental understanding and treatment of risk, particularly non-routine or disruption related risk. This paper presents a number of conceptual models of organisational resilience that we have developed to demonstrate the range of inter-dependant factors that need to be considered in the management of such risk. These conceptual models illustrate that effective resilience is built upon a range of different strategies that enhance both ‘hard’ and ‘soft’ organisational capabilities . They emphasise the concept that there is no quick fix, no single process, management system or software application that will create resilience.

The organisation : risk, resilience and governance

Tarrant argues that a solid risk management strategy is critical to building effective, transformational and adaptive organisations. Organisations are a fundamental part of our society and economic system whether they are private, public or not-for-profits. There are very few aspects of our society and economy that don’t rely wholly or in part on the performance of organisations. Disasters and crises are complex and very challenging environments for organisations. How can effective transformational and adaptive capacity become institutionalised and a core part of good governance of organisations? Effective risk management is a critical element in meeting organisational objectives in a turbulent and uncertain environment.

Introduction : the South Asia Infant Feeding Research Network (SAIFRN)

The South Asia Infant Feeding Research Network (SAIFRN) was established in 2007 to foster and coordinate a research partnership among South Asian and international research groups interested in infant and young child feeding. SAIFRN has brought together a mix of researchers and program managers from Bangladesh, India, Nepal, Pakistan, and Sri Lanka together with international partners from Australia. As the first activity, SAIFRN conducted a series of analyses using Demographic and Health Surveys of Bangladesh, Nepal, and Sri Lanka and the National Family Health Survey of India. The results highlight that most indicators of infant and young child feeding in these four countries have not reached the targeted levels. The rates vary considerably by country, and the factors associated with poor feeding practices were not always consistent across countries. Driven by the ultimate goal of improved child survival in the region, SAIFRN wishes to expand its partnerships with governmental and nongovernmental organizations that share common interests both within and outside the South Asia region. In the future, SAIFRN hopes to provide more opportunities to researchers in the region to improve their skills by participating in capacity-building programs in collaboration with international partner institutions, and looks forward to liaising with potential donors to support such activities.