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.

Preliminary study on bridge health prediction using Dynamic Objective Oriented Bayesian Network (DOOBN)

The availability of bridges is crucial to people’s daily life and national economy. Bridge health prediction plays an important role in bridge management because maintenance optimization is implemented based on prediction results of bridge deterioration. Conventional bridge deterioration models can be categorised into two groups, namely condition states models and structural reliability models. Optimal maintenance strategy should be carried out based on both condition states and structural reliability of a bridge. However, none of existing deterioration models considers both condition states and structural reliability. This study thus proposes a Dynamic Objective Oriented Bayesian Network (DOOBN) based method to overcome the limitations of the existing methods. This methodology has the ability to act upon as a flexible unifying tool, which can integrate a variety of approaches and information for better bridge deterioration prediction. Two demonstrative case studies are conducted to preliminarily justify the feasibility of the methodology

Defences in medical negligence : to what extent has tort law reform in Australia limited the liability of health professionals?

Tort law reform has resulted in legislation being passed by all Australian jurisdictions in the past decade implementing the recommendations contained in the Ipp Report. The report was in response to a perceived crisis in medical indemnity insurance. The objective was to restrict and limit liability in negligence actions. This paper will consider to what extent the reforms have impacted on the liability of health professionals in medical negligence actions. After an analysis of the legislation, it will be argued in this paper that while there has been some limitation and restriction, courts have generally interpreted the civil liability reforms in compliance with the common law. It has been the impact of statutory limits on the assessment of damages through thresholds and caps which has limited the liability of health professionals in medical negligence actions.

Clinical strategies for the alleviation of contractures from a predictive mathematical model of dermal repair

Hypertrophic scars arise when there is an overproduction of collagen during wound healing. These are often associated with poor regulation of the rate of programmed cell death(apoptosis) of the cells synthesizing the collagen or by an exuberant inflammatory response that prolongs collagen production and increases wound contraction. Severe contractures that occur, for example, after a deep burn can cause loss of function especially if the wound is over a joint such as the elbow or knee. Recently, we have developed a morphoelastic mathematical model for dermal repair that incorporates the chemical, cellular and mechanical aspects of dermal wound healing. Using this model, we examine pathological scarring in dermal repair by first assuming a smaller than usual apoptotic rate for myofibroblasts, and then considering a prolonged inflammatory response, in an attempt to determine a possible optimal intervention strategy to promote normal repair, or terminate the fibrotic scarring response. Our model predicts that in both cases it is best to apply the intervention strategy early in the wound healing response. Further, the earlier an intervention is made, the less aggressive the intervention required. Finally, if intervention is conducted at a late time during healing, a significant intervention is required; however, there is a threshold concentration of the drug or therapy applied, above which minimal further improvement to wound repair is obtained.

'Any body is better than nobody?' Ethical questions around recruiting and/or retaining health professionals in rural areas

The literature on recruiting and/or retaining health professionals in rural areas focuses primarily on the development of recruitment and retention strategies and assessing whether such strategies are effective. The objective of this article is to argue that it is important for all stakeholders involved in rural recruitment and/or retention processes to consider their decisions and actions from an ethics perspective. Recruitment and/or retention processes are not value neutral and it is important to understand their ethical dimensions. Methods: From the literature, elements of the recruitment and/or retention strategies that have been employed were identified and organised in respect of levels of governance (namely, the levels of health system/government, community, and individual health professionals). The elements identified in these levels were subjected to analysis to identify their ethical dimensions and to determine whether a clash or complement of values arose at each level of governance or between governance levels. Results: There is very little literature in this area that considers the ethical dimensions of rural recruitment and/or retention processes. However, all policies and practices have ethical dimensions that need to be identified and understood as they may have significant implications for recruitment and/or retention processes. Conclusion: This article recommends the application of an ethics perspective when reflecting on rural recruitment and/or retention strategies. The collective decisions of all involved in rural recruitment and/or retention processes may fundamentally influence the 'health' (broadly understood) of rural communities.

Engaging law students to promote psychological health

Recent empirical evidence suggests that concern for the psychological health of law students is well justified. Traditionally, the legal curriculum has focused on the provision of substantive legal doctrinal knowledge. This approach has not always engaged students positively with their learning of law. This article considers some strategies that can be adopted by Law Faculties to better engage students with their legal education in order to promote their psychological health. These strategies are: ensuring that active learning occurs in lectures, demonstrating concern for students and their learning and skillful management of student expectations and the learning environment. Further, some self-help strategies that students can adopt for themselves are discussed. Combined, these strategies will enable students to engage more positively with their legal education.

A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer : exercise for health

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas. This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer. A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70). Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity. Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions.

A review of commuter exposure to ultrafine particles and its health effects

Ultrafine particles (UFPs, <100 nm) are produced in large quantities by vehicular combustion and are implicated in causing several adverse human health effects. Recent work has suggested that a large proportion of daily UFP exposure may occur during commuting. However, the determinants, variability and transport mode-dependence of such exposure are not well-understood. The aim of this review was to address these knowledge gaps by distilling the results of ‘in-transit’ UFP exposure studies performed to-date, including studies of health effects. We identified 47 exposure studies performed across 6 transport modes: automobile, bicycle, bus, ferry, rail and walking. These encompassed approximately 3000 individual trips where UFP concentrations were measured. After weighting mean UFP concentrations by the number of trips in which they were collected, we found overall mean UFP concentrations of 3.4, 4.2, 4.5, 4.7, 4.9 and 5.7 × 10^4 particles cm^-3 for the bicycle, bus, automobile, rail, walking and ferry modes, respectively. The mean concentration inside automobiles travelling through tunnels was 3.0 × 10^5 particles cm^-3. While the mean concentrations were indicative of general trends, we found that the determinants of exposure (meteorology, traffic parameters, route, fuel type, exhaust treatment technologies, cabin ventilation, filtration, deposition, UFP penetration) exhibited marked variability and mode-dependence, such that it is not necessarily appropriate to rank modes in order of exposure without detailed consideration of these factors. Ten in-transit health effects studies have been conducted and their results indicate that UFP exposure during commuting can elicit acute effects in both healthy and health-compromised individuals. We suggest that future work should focus on further defining the contribution of in-transit UFP exposure to total UFP exposure, exploring its specific health effects and investigating exposures in the developing world. Keywords: air pollution; transport modes; acute health effects; travel; public transport

Smart Measures for Sustainable Outcomes: Integrated Considerations for Sustainable Refurbishment of Office Buildings

The increasing stock of aging office buildings will see a significant growth in retrofitting projects in Australian capital cities. Stakeholders of refitting works will also need to take on the sustainability challenge and realize tangible outcomes through project delivery. Traditionally, decision making for aged buildings, when facing the alternatives, is typically economically driven and on ad hoc basis. This leads to the tendency to either delay refitting for as long as possible thus causing building conditions to deteriorate, or simply demolish and rebuild with unjust financial burden. The technologies involved are often limited to typical strip-clean and repartition with dry walls and office cubicles. Changing business operational patterns, the efficiency of office space, and the demand on improved workplace environment, will need more innovative and intelligent approaches to refurbishing office buildings. For example, such projects may need to respond to political, social, environmental and financial implications. There is a need for the total consideration of buildings structural assessment, modeling of operating and maintenance costs, new architectural and engineering designs that maximise the utility of the existing structure and resulting productivity improvement, specific construction management procedures including procurement methods, work flow and scheduling and occupational health and safety. Recycling potential and conformance to codes may be other major issues. This paper introduces examples of Australian research projects which provided a more holistic approach to the decision making of refurbishing office space, using appropriate building technologies and products, assessment of residual service life, floor space optimisation and project procurement in order to bring about sustainable outcomes. The paper also discusses a specific case study on critical factors that influence key building components for these projects and issues for integrated decision support when dealing with the refurbishment, and indeed the “re-life”, of office buildings.

Information Accountability Framework for a Trusted Health Care System

Trusted health care outcomes are patient centric. Requirements to ensure both the quality and sharing of patients’ health records are a key for better clinical decision making. In the context of maintaining quality health, the sharing of data and information between professionals and patients is paramount. This information sharing is a challenge and costly if patients’ trust and institutional accountability are not established. Establishment of an Information Accountability Framework (IAF) is one of the approaches in this paper. The concept behind the IAF requirements are: transparent responsibilities, relevance of the information being used, and the establishment and evidence of accountability that all lead to the desired outcome of a Trusted Health Care System. Upon completion of this IAF framework the trust component between the public and professionals will be constructed. Preservation of the confidentiality and integrity of patients’ information will lead to trusted health care outcomes.