Application of an appearance-based intervention to improve sun protection outcomes of outdoor workers in Queensland, Australia

Outdoor workers are exposed to high levels of ultraviolet radiation (UVR) and may thus be at greater risk to experience UVR-related health effects such as skin cancer, sun burn, and cataracts. A number of intervention trials (n=14) have aimed to improve outdoor workers’ work-related sun protection cognitions and behaviours. Only one study however has reported the use of UV-photography as part of a multi-component intervention. This study was performed in the USA and showed long-term (12 months) improvements in work-related sun protection behaviours. Intervention effects of the other studies have varied greatly, depending on the population studied, intervention applied, and measurement of effect. Previous studies have not assessed whether: - Interventions are similarly effective for workers in stringent and less stringent policy organisations; - Policy effect is translated into workers’ leisure time protection; - Implemented interventions are effective in the long-term; - The facial UV-photograph technique is effective in Australian male outdoor workers without a large additional intervention package, and; - Such interventions will also affect workers’ leisure time sun-related cognitions and behaviours. Therefore, the present Protection of Outdoor Workers from Environmental Radiation [POWER]-study aimed to fill these gaps and had the objectives of: a) assessing outdoor workers’ sun-related cognitions and behaviours at work and during leisure time in stringent and less stringent sun protection policy environments; b) assessing the effect of an appearance-based intervention on workers’ risk perceptions, intentions and behaviours over time; c) assessing whether the intervention was equally effective within the two policy settings; and d) assessing the immediate post-intervention effect. Effectiveness was described in terms of changes in sun-related risk perceptions and intentions (as these factors were shown to be main precursors of behaviour change in many health promotion theories) and behaviour. The study purposefully selected and recruited two organisations with a large outdoor worker contingent in Queensland, Australia within a 40 kilometre radius of Brisbane. The two organisations differed in the stringency of implementation and reinforcement of their organisational sun protection policy. Data were collected from 154 male predominantly Australian born outdoor workers with an average age of 37 years and predominantly medium to fair skin (83%). Sun-related cognitions and behaviours of workers were assessed using self-report questionnaires at baseline and six to twelve months later. Variation in follow-up time was due to a time difference in the recruitment of the two organisations. Participants within each organisation were assigned to an intervention or control group. The intervention group participants received a one-off personalised Skin Cancer Risk Assessment Tool [SCRAT]-letter and a facial UV-photograph with detailed verbal information. This was followed by an immediate post-intervention questionnaire within three months of the start of the study. The control group only received the baseline and follow-up questionnaire. Data were analysed using a variety of techniques including: descriptive analyses, parametric and non-parametric tests, and generalised estimating equations. A 15% proportional difference observed was deemed of clinical significance, with the addition of reported statistical significance (p<0.05) where applicable. Objective 1: Assess and compare the current sun-related risk perceptions, intentions, behaviours, and policy awareness of outdoor workers in stringent and less stringent sun protection policy settings. Workers within the two organisations (stringent n=89 and less stringent n=65) were similar in their knowledge about skin cancer, self efficacy, attitudes, and social norms regarding sun protection at work and during leisure time. Participants were predominantly in favour of sun protection. Results highlighted that compared to workers in a less stringent policy organisation working for an organisation with stringent sun protection policies and practices resulted in more desirable sun protection intentions (less willing to tan p=0.03) ; actual behaviours at work (sufficient use of upper and lower body protection, headgear, and sunglasses (p<0.001 for all comparisons), and greater policy awareness (awareness of repercussions if Personal Protective Equipment (PPE) was not used, p<0.001)). However the effect of the work-related sun protection policy was found not to extend to leisure time sun protection. Objective 2: Compare changes in sun-related risk perceptions, intentions, and behaviours between the intervention and control group. The effect of the intervention was minimal and mainly resulted in a clinically significant reduction in work-related self-perceived risk of developing skin cancer in the intervention compared to the control group (16% and 32% for intervention and control group, respectively estimated their risk higher compared to other outdoor workers: , p=0.11). No other clinical significant effects were observed at 12 months follow-up. Objective 3: Assess whether the intervention was equally effective in the stringent sun protection policy organisation and the less stringent sun protection policy organisation. The appearance-based intervention resulted in a clinically significant improvement in the stringent policy intervention group participants’ intention to protect from the sun at work (workplace*time interaction, p=0.01). In addition to a reduction in their willingness to tan both at work (will tan at baseline: 17% and 61%, p=0.06, at follow-up: 54% and 33%, p=0.07, stringent and less stringent policy intervention group respectively. The workplace*time interaction was significant p<0.001) and during leisure time (will tan at baseline: 42% and 78%, p=0.01, at follow-up: 50% and 63%, p=0.43, stringent and less stringent policy intervention group respectively. The workplace*time interaction was significant p=0.01) over the course of the study compared to the less stringent policy intervention group. However, no changes in actual sun protection behaviours were found. Objective 4: Examine the effect of the intervention on level of alarm and concern regarding the health of the skin as well as sun protection behaviours in both organisations. The immediate post-intervention results showed that the stringent policy organisation participants indicated to be less alarmed (p=0.04) and concerned (p<0.01) about the health of their skin and less likely to show the facial UV-photograph to others (family p=0.03) compared to the less stringent policy participants. A clinically significantly larger proportion of participants from the stringent policy organisation reported they worried more about skin cancer (65%) and skin freckling (43%) compared to those in the less stringent policy organisation (46%,and 23% respectively , after seeing the UV-photograph). In summary the results of this study suggest that the having a stringent work-related sun protection policy was significantly related to for work-time sun protection practices, but did not extend to leisure time sun protection. This could reflect the insufficient level of sun protection found in the general Australian population during leisure time. Alternatively, reactance caused by being restricted in personal decisions through work-time policy could have contributed to lower leisure time sun protection. Finally, other factors could have also contributed to the less than optimal leisure time sun protection behaviours reported, such as unmeasured personal or cultural barriers. All these factors combined may have lead to reduced willingness to take proper preventive action during leisure time exposure. The intervention did not result in any measurable difference between the intervention and control groups in sun protection behaviours in this population, potentially due to the long lag time between the implementation of the intervention and assessment at 12-months follow-up. In addition, high levels of sun protection behaviours were found at baseline (ceiling effect) which left little room for improvement. Further, this study did not assess sunscreen use, which was the predominant behaviour assessed in previous effective appearance-based interventions trials. Additionally, previous trials were mainly conducted in female populations, whilst the POWER-study’s population was all male. The observed immediate post-intervention result could be due to more emphasis being placed on sun protection and risks related to sun exposure in the stringent policy organisation. Therefore participants from the stringent policy organisation could have been more aware of harmful effects of UVR and hence, by knowing that they usually protect adequately, not be as alarmed or concerned as the participants from the less stringent policy organisation. In conclusion, a facial UV-photograph and SCRAT-letter information alone may not achieve large changes in sun-related cognitions and behaviour, especially of assessed 6-12 months after the intervention was implemented and in workers who are already quite well protected. Differences found between workers in the present study appear to be more attributable to organisational policy. However, against a background of organisational policy, this intervention may be a useful addition to sun-related workplace health and safety programs. The study findings have been interpreted while respecting a number of limitations. These have included non-random allocation of participants due to pre-organised allocation of participants to study group in one organisation and difficulty in separating participants from either study group. Due to the transient nature of the outdoor worker population, only 105 of 154 workers available at baseline could be reached for follow-up. (attrition rate=32%). In addition the discrepancy in the time to follow-up assessment between the two organisations was a limitation of the current study. Given the caveats of this research, the following recommendations were made for future research: - Consensus should be reached to define "outdoor worker" in terms of time spent outside at work as well as in the way sun protection behaviours are measured and reported. - Future studies should implement and assess the value of the facial UV-photographs in a wide range of outdoor worker organisations and countries. - More timely and frequent follow-up assessments should be implemented in intervention studies to determine the intervention effect and to identify the best timing of booster sessions to optimise results. - Future research should continue to aim to target outdoor workers’ leisure time cognitions and behaviours and improve these if possible. Overall, policy appears to be an important factor in workers’ compliance with work-time use of sun protection. Given the evidence generated by this research, organisations employing outdoor workers should consider stringent implementation and reinforcement of a sun protection policy. Finally, more research is needed to improve ways to generate desirable behaviour in this population during leisure time.

Cultural safety : cultural considerations

Over the course of your nursing professional education, you will study the developmental tasks and the principles of health promotion across the life span. You will learn to conduct numerous assessments, such as a complete health history, a psycho-social history, a mental health assessment, a nutritional assessment, a pain assessment, a suicide risk assessment and a physical examination of a patient. However, depending on your reactions to the person there may be wide variations in the information you gather in these assessments and in the findings of the physical examination. In the 1980s there was a change in western nurse education that recognised the interaction between culture and health and since then many nursing degrees include cultural considerations in their Bachelor Programs. It is now imperative that you, as a health care provider, come to understand how culture influences health care.

Beyond the inner city : real and imagined places in creative place policy and practice

As the economic and social benefits of creative industries development become increasingly visible, policymakers worldwide are working to create policy drivers to ensure that certain places become or remain ‘creative places’. Richard Florida’s work has become particularly influential among policymakers, as has Landry’s. But as the first wave of creative industrial policy development and implementation wanes, important questions are emerging. It is by now clear that an ‘ideal creative place’ has arisen from creative industries policy and planning literature, and that this ideal place is located in inner cities. This article shifts its focus away from the inner city to where most Australians live: the outer suburbs. It reports on a qualitative research study into the practices of outer-suburban creative industries workers in Redcliffe, Australia. It argues that the accepted geography of creative places requires some recalibration once the material and experiential aspects of creative places are taken into account.

Creative industries after the first decade of debate

It has now been over a decade since the concept of creative industries was first put into the public domain by the Blair Labour government’s Creative Industries Mapping Documents in Britain. The concept has gained traction globally, but it has also been understood and developed in different ways in Europe, Asia, Australia, New Zealand, and North America, as well as through international bodies such as UNCTAD and UNESCO. A review of the policy literature reveals that although questions and issues remain around definitional coherence, there is some degree of consensus emerging about the size, scope, and significance of the sectors in question in both advanced and developing economies. At the same time, debate about the concept remains highly animated in media, communication, and cultural studies, with its critics dismissing the concept outright as a harbinger of neoliberal ideology in the cultural sphere. This article couches such critiques in light of recent debates surrounding the intellectual coherence of the concept of neoliberalism, arguing that this term itself possesses problems when taken outside of the Anglo-American context in which it originated. It is argued that issues surrounding the nature of participatory media culture, the relationship between cultural production and economic innovation, and the future role of public cultural institutions can be developed from within a creative industries framework and that writing off such arguments as a priori ideological and flawed does little to advance debates about twentieth-century information and media culture.

Creative Industries and Urban Development : Creative Cities in the 21st Century

"The concept of creative industries has developed considerable academic and policy momentum in the 21st century. There has been a connection identified between the rise of creative industries and the urbanisation of the world’s population, particularly in relation to the significance of cities as sites of cultural production and consumption. Much of the work on creative industries and cities, however, has drawn upon 'imagined geographies' about the relationship between creativity and place. This collection draws together contributions that critically appraise recent urban cultural policy discourses, as well as reflecting on the role of culture and creative industries in the future development of cities."---publisher website

Developing a creative cluster in a post-industrial city : the Creative Industries Development Service (CIDS) and Manchester

This article takes the establishment and demise of Manchester’s Creative Industries Development Service (CIDS) as an exemplary case study for the ways in which creative industry policy has intersected with urban economic policy over the last decade. The authors argue that the creative industries required specific kinds of economic development agencies that would be able to act as “intermediaries” between the distinct languages of policymakers and “creatives.” They discuss the tensions inherent in such an approach and how CIDS attempted to manage them and suggest that the main reason for the demise of the CIDS was the domination of the “economic” over the “cultural” logic, both of which are present within the creative industries policy discourse.

Can Beijing become a global media capital?

The commercialization of Chinese media has taken place over the past two decades; it has become a significant force since 2001 when China joined the World Trade Organisation. With demand for original content increasing and China contemplating a cultural trade deficit in media content, there is much discussion of agglomeration and clustering. Beijing, as the national media centre of China, witnesses a process of media agglomeration while bearing the problem of cultural export during the media commercialization. Michael Curtin‟s idea of media capital, which absorbs media resources and personnel and exports media products transnationally, provides a dynamic perspective of understanding media agglomeration and dispersion under different political social and cultural circumstances. Hence the question whether Beijing is going to transform into a transnational media capital is worth studying, in order to observe and comprehend China‟s media industry in transition. Drawing on Michael Curtin‟s three media capital trajectories, the paper interprets tensions and challenges generated in the process of media industry agglomeration and growth in Beijing. Emphasis is placed on the third trajectory, socio-cultural variation.

Researcher attitudes to data sharing : cultural change requires better motivations

While undertaking the ANDS RDA Gold Standard Record Exemplars project, research data sharing was discussed with many QUT researchers. Our experiences provided rich insight into researcher attitudes towards their data and the sharing of such data. Generally, we found traditional altruistic motivations for research data sharing did not inspire researchers, but an explanation of the more achievement-oriented benefits were more compelling.

Normative influences across cultures : conceptual differences and potential confounders among drivers in Australia and China

Normative influences on road user behaviour have been well documented and include such things as personal, group, subjective and moral norms. Commonly, normative factors are examined within one cultural context, although a few examples of exploring the issue across cultures exist. Such examples add to our understanding of differences in perceptions of the normative factors that may exert influence on road users and can assist in determining whether successful road safety interventions in one location may be successful in another. Notably, the literature is relatively silent on such influences in countries experiencing rapidly escalating rates of motorization. China is one such country where new drivers are taking to the roads in unprecedented numbers and authorities are grappling with the associated challenges. This paper presents results from qualitative and quantitative research on self-reported driving speeds of car drivers and related issues in Australia and China. Focus group interviews and questionnaires conducted in each country examined normative factors that might influence driving in each cultural context. Qualitative findings indicated perceptions of community acceptance of speeding were present in both countries but appeared more widespread in China, yet quantitative results did not support this difference. Similarly, with regard to negative social feedback from speeding, qualitative findings suggested no embarrassment associated with speeding among Chinese participants and mixed results among Australian participants, yet quantitative results indicated greater embarrassment for Chinese drivers. This issue was also examined from the perspective of self-identity and findings were generally similar across both samples and appear related to whether it is important to be perceived as a skilled/safe driver by others. An interesting and important finding emerged with regard to how Chinese drivers may respond to questions about road safety issues if the answers might influence foreigners’ perceptions of China. In attempting to assess community norms associated with speeding, participants were asked to describe what they would tell a foreign visitor about the prevalence of speeding in China. Responses indicated that if asked by a foreigner, people may answer in a manner that portrayed China as a safe country (e.g., that drivers do not speed), irrespective of the actual situation. This ‘faking good for foreigners’ phenomenon highlights the importance of considering ‘face’ when conducting research in China – a concept absent from the road safety literature. An additional noteworthy finding that has been briefly described in the road safety literature is the importance and strength of the normative influence of social networks (guanxi) in China. The use of personal networks to assist in avoiding penalties for traffic violations was described by Chinese participants and is an area that could be addressed to strengthen the deterrent effect of traffic law enforcement. Overall, the findings suggest important considerations for developing and implementing road safety countermeasures in different cultural contexts.

The Australian curriculum : implications for teaching and assessment

Teachers will be aware of the raft of educational changes introduced recently and also of the associated challenges and opportunities that such educational reforms present. This PETAA Paper commences with an overview of the major educational changes and how they impinge on teachers’ classroom practice in the teaching of English and makes explicit the implications for policy support. This article aims to provide teachers with some insight into how they might respond in their teaching to develop their own assessment and pedagogic practices and in so doing support students to improve in their learning and to achieve higher standards. A group of teachers’ classroom practice, which has applicability to both Upper Primary and Middle School English teaching, is analysed to demonstrate how these teachers have pedagogically incorporated some of the ‘general capabilities’ and a cross-curriculum priority of ‘Aboriginal and Torres Strait Islander histories and cultures’ into their classroom practice.

A randomised controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson’s disease: study rationale and protocol

Parkinson’s disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson’s disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.

What to do if your child is being bullied

Many of us have experienced being a victim of a bully at some time in our lives. We know how humiliated and hurt we were. If you find out your child is being bullied we want to jump in and sort it out straight away. However, it is better to remain clam and have a conversation with your child, not an interrogation and make a plan. About a quarter of children say they have been bullied at some time and yet many will not tell us for fear of retaliation from the bully or because of what we might do.

Cyberbullying

Cyberbullying is any bullying through technology, usually using mobile phones and the Internet or combinations of these. Methods used to bully include texting degoratory messages on mobile phones with young people showing them to their friends before sending to the victim; slagging or excluding someone in a chat room; inviting comments on nasty blogs or placing embarrassing or bullying videos on YouTube. It is important to distinguish if it is bullying or fighting using technology because that determines how it is best handled. Just because young people send a nasty text or use instant messaging to berate someone, it could be fighting between equals and not the intentional, aggressive, repeated acts of someone with more power which defines bullying.

Multimodal approaches to reflective teaching and assessment in higher education

Reflection is not a new concept in the teaching of higher education and is often an important component of many disciplinary courses. Despite this, past research shows that whilst there are examples of rich reflective strategies used in some areas of higher education, most approaches to and conceptualisations of reflective learning and assessment have been perfunctory and inconsistent. In many disciplinary areas reflection is often assessed as a written activity ‘tagged onto’ assessment practices. In creative disciplines however, reflective practice is an integral and cumulative form of learning and is often expressed in ways other than in the written form. This paper will present three case studies of reflective practice in the area of Creative Industries in higher education – Dance, Fashion and Music. It will discuss the ways in which higher education teachers and students use multi-modal approaches to expressing knowledge and reflective practice in context. The paper will argue that unless students are encouraged to participate in deep reflective disciplinary discourse via multi-modes then reflection will remain superficial in the higher education context.

Moving beyond transition pedagogy: Maturity models and student engagement

Australian higher education institutions (HEIs) have entered a new phase of regulation and accreditation which includes performance-based funding relating to the participation and retention of students from social and cultural groups previously underrepresented in higher education. However, in addressing these priorities, it is critical that HEIs do not further disadvantage students from certain groups by identifying them for attention because of their social or cultural backgrounds, circumstances which are largely beyond the control of students. In response, many HEIs are focusing effort on university-wide approaches to enhancing the student experience because such approaches will enhance the engagement, success and retention of all students, and in doing so, particularly benefit those students who come from underrepresented groups. Measuring and benchmarking student experiences and engagement that arise from these efforts is well supported by extensive collections of student experience survey data. However no comparable instrument exists that measures the capability of institutions to influence and/or enhance student experiences where capability is an indication of how well an organisational process does what it is designed to do (Rosemann & de Bruin, 2005). This paper proposes that the concept of a maturity model (Marshall, 2010; Paulk, 1999) may be useful as a way of assessing the capability of HEIs to provide and implement student engagement, success and retention activities. We will describe the Student Engagement, Success and Retention Maturity Model (SESR-MM), (Clarke, Nelson & Stoodley, 2012; Nelson, Clarke & Stoodley, 2012) we are currently investigating. We will discuss if our research may address the current gap by facilitating the development of an SESR-MM instrument that aims (i) to enable institutions to assess the capability of their current student engagement and retention programs and strategies to influence and respond to student experiences within the institution; and (ii) to provide institutions with the opportunity to understand various practices across the sector with a view to further improving programs and practices relevant to their context. The first aim of our research is to extend the generational approach which has been useful in considering the evolutionary nature of the first year experience (FYE) (Wilson, 2009). Three generations have been identified and explored: First generation approaches that focus on co-curricular strategies (e.g. orientation and peer programs); Second generation approaches that focus on curriculum (e.g. pedagogy, curriculum design, and learning and teaching practice); and third generation approaches—also referred to as transition pedagogy—that focus on the production of an institution-wide integrated holistic intentional blend of curricular and co-curricular activities (Kift, Nelson & Clarke, 2010). The second aim of this research is to move beyond assessments of students’ experiences to focus on assessing institutional processes and their capability to influence student engagement. In essence, we propose to develop and use the maturity model concept to produce an instrument that will indicate the capability of HEIs to manage and improve student engagement, success and retention programs and strategies. References Australian Council for Educational Research. (n.d.). Australasian Survey of Student Engagement. Retrieved from http://www.acer.edu.au/research/ausse/background Clarke, J., Nelson, K., & Stoodley, I. (2012, July). The Maturity Model concept as framework for assessing the capability of higher education institutions to address student engagement, success and retention: New horizon or false dawn? A Nuts & Bolts presentation at the 15th International Conference on the First Year in Higher Education, “New Horizons,” Brisbane, Australia. Kift, S., Nelson, K., & Clarke, J. (2010) Transition pedagogy - a third generation approach to FYE: A case study of policy and practice for the higher education sector. The International Journal of the First Year in Higher Education, 1(1), pp. 1-20. Department of Education, Employment and Workplace Relations. (n.d.). The University Experience Survey. Advancing quality in higher education information sheet. Retrieved from http://www.deewr.gov.au/HigherEducation/Policy/Documents/University_Experience_Survey.pdf Marshall, S. (2010). A quality framework for continuous improvement of e-Learning: The e-Learning Maturity Model. Journal of Distance Education, 24(1), 143-166. Nelson, K., Clarke, J., & Stoodley, I. (2012). An exploration of the Maturity Model concept as a vehicle for higher education institutions to assess their capability to address student engagement. A work in progress. Submitted for publication. Paulk, M. (1999). Using the Software CMM with good judgment, ASQ Software Quality Professional, 1(3), 19-29. Wilson, K. (2009, June–July). The impact of institutional, programmatic and personal interventions on an effective and sustainable first-year student experience. Keynote address presented at the 12th Pacific Rim First Year in Higher Education Conference, “Preparing for Tomorrow Today: The First Year as Foundation,” Townsville, Australia. Retrieved from http://www.fyhe.com.au/past_papers/papers09/ppts/Keithia_Wilson_paper.pdf