Best practice for prevention and treatment of cardiovascular disease through an equity lens : a review

Background Despite declining rates of cardiovascular disease (CVD) mortality in developed countries, lower socioeconomic groups continue to experience a greater burden of the disease. There are now many evidence-based treatments and prevention strategies for the management of CVD and it is essential that their impact on the more disadvantaged group is understood if socioeconomic inequalities in CVD are to be reduced.

Aims To determine whether key interventions for CVD prevention and treatment are effective among lower socioeconomic groups, to describe barriers to their effectiveness and the potential or actual impact of these interventions on the socioeconomic gradient in CVD.

Methods Interventions were selected from four stages of the CVD continuum. These included smoking reduction strategies, absolute risk assessment, cardiac rehabilitation, secondary prevention medications, and heart failure self-management programmes. Electronic searches were conducted using terms for each intervention combined with terms for socioeconomic status (SES).

Results Only limited evidence was found for the effectiveness of the selected interventions among lower SES groups and there was little exploration of socioeconomic-related barriers to their uptake. Some broad themes and key messages were identified. In the majority of findings examined, it was clear that the underlying material, social and environmental factors associated with disadvantage are a significant barrier to the effectiveness of interventions.

Conclusion Opportunities to reduce socioeconomic inequalities occur at all stages of the CVD continuum. Despite this, current treatment and prevention strategies may be contributing to the widening socioeconomic-CVD gradient. Further research into the impact of best-practice interventions for CVD upon lower SES groups is required.

An outdoor and environmental education community of practice : self stylisation or normalisation?

In this article, I draw on a qualitative longitudinal study to explore the influence of a tertiary Outdoor and Environmental Education (OEE) course on the formation of environmental ethics among students. In this task, I bring together Lave & Wenger (1991) and Wenger’s (1998) concept of communities of practice and Michel Foucault’s later work on ethics to underscore some of the difficulties of an OEE community of practice as a space for (environmentally) ethical self-stylisation. Bringing these theoretical ideas together is significant because my analysis suggests that the OEE community of practice (re)produces an environmental ethic based on normalised codes of conduct rather than a self-fashioning of an ethical existence as conceived by Foucault. I demonstrate that membership in overlapping communities of practice is influential in participants’ performance of environmental identities and normalising codes of conduct are particularly significant in the physical education/pre-service education communities of practice of which participants are members.

Tariff and environmental policies with product standards

For a small open economy with consumption-based pollution emissions, the first-best optimal policy prescription is free trade along with a Pigouvian tax on emissions. Therefore, a package of coordinated tax reform by replacing tariffs with emission taxes can lower pollution emissions and increase market access and hence improve residents’ welfare and government revenue, as long as the initial tariffs are relatively high. Numerical simulations confirm the results obtained.

Social and professional participation of individuals who are deaf : utilizing the psychosocial potential maximization framework

This article documents a strength-based understanding of how individuals who are deaf maximize their social and professional potential. This exploratory study was conducted with 49 adult participants who are deaf (n ¼ 30) and who have typical hearing (n ¼ 19) residing in America, Australia, England, and South Africa. The findings support a systematic and comprehensive framework of proactive psychosocial attributes and tactics. Statistical analysis showed no significant differences between the groups across four variables of psychosocial competencies. Qualitative data further suggests that participants who are deaf maximize their potential using two types of proactive psychosocial attributes and tactics: 1) skills that individuals with typical hearing use and 2) specialized skills for identifying, circumventing, or mastering deafness-related difficulties. These findings contribute to understandings of how individuals who are deaf can achieve social and professional success.

Understanding determinants of nutrition, physical activity and quality of life among older adults : the Wellbeing, Eating and Exercise for a Long Life (WELL) study

Background : Nutrition and physical activity are major determinants of health and quality of life; however, there exists little research focusing on determinants of these behaviours in older adults. This is important, since just as these behaviours vary according to subpopulation, it is likely that the determinants also vary. An understanding of the modifiable determinants of nutrition and physical activity behaviours among older adults to take into account the specific life-stage context is required in order to develop effective interventions to promote health and well-being and prevent chronic disease and improve quality of life.

Methods : The aim of this work is to identify how intrapersonal, social and environmental factors influence nutrition and physical activity behaviours among older adults living in urban and rural areas. This study is a cohort study of adults aged 55-65 years across urban and rural Victoria, Australia. Participants completed questionnaires at baseline in 2010 and will complete follow-up questionnaires in 2012 and 2014. Self-report questionnaires will be used to assess outcomes such as food intake, physical activity and sedentary behaviours, anthropometry and quality of life. Explanatory variables include socioeconomic position, and measures of the three levels of influence on older adults' nutrition and physical activity behaviours (intrapersonal, social and perceived environmental influences).

Discussion : Obesity and its determinant behaviours, physical inactivity and poor diet are major public health concerns and are significant determinants of the quality of life among the ageing population. There is a critical need for a better understanding of the determinants of nutrition and physical activity in this important target group. This research will provide evidence for the development of effective policies and programs to promote and support increased physical activity and healthy eating behaviours among older adults.

The simple yet complex development of social and participatory media for classroom learning : building a hybrid learning environment through action research

This paper reports on part of a teacher/researcher’s PhD action research study. It explains the complexity of features that social media brings to the teaching and learning process while discussing the simplicity and power of its use. Through the action research cycle, learning programs were designed to take advantage of the unique communicative methods offered by social media and web 2.0 whilst maintaining the value of face-to-face learning. Students used social media spaces such as blogs, groups and discussion forums as well as developing their own profiles and avatars to communicate online by making friends, leaving comments and uploading content which included publishing, peer reviewing and self assessment. The author argues that, by designing learning that valued and combined the attributes of social media, Web 2.0 and face-to-face teaching she was able to produce a more student-centred approach; hence, developing a ‘Hybrid’ learning environment which supported many 21st Century skills.

Sustainability evaluation, life cycle assessment and facilities management for Geelong Retail Development

Value management is a technique used during the design stage to justify cost and worth of a proposal. Designer must never center only to save capital expenditure but consider holistically the whole building life which will be sustainable. Therefore, sustainability evaluation must adopt a long term view and will properly include three crucial elements: economic, social and environmental. Lack of awareness of value management during the design stage of a building project will adversely impact on the life cycle assessment (LCA) and facilities management (FM). This paper provides a review of the sustainable elements that must be considered when designing and costing a new retail development in the Geelong region of Australia and how these factors influence the whole building life. The result of this research helps to create a greater understanding of the different attributes that will affect the LCA and FM decisions made on sustainable development in this and other regional Australian cities that are undergoing major population growth.

The politics of coastal policy, planning and governance in Canada and Australia : business as usual, at a distance, or collaborative?

Canada and Australia are countries with substantial coastal zones which provide significant economic, social and environmental benefits and opportunities. The coastal zones of Canada and Australia also share significant threats such as, pollution, loss of biodiversity, and climate change, while also facing different challenges that are unique to their particular contexts. Effective management of such zones therefore represents a considerable challenge because of the: complexity of biophysical processes; multiple threats faced; uncertainties associated with understandings of such processes and threats, and the multiple jurisdictions and stakeholder viewpoints as to how such environments should be managed. Further, coasts and the sustainability of coastal resources and ecosystems have been argued to represent ‘wicked problems’ such that their governability is called into question. Therefore drawing on recent experiences in coastal policy, planning and governance in Newfoundland, Canada, and Victoria, Australia, this paper assesses the adequacy of current approaches to coastal governance in the two jurisdictions. In doing so we draw on recent policy and governance literature to consider whether coastal policy, planning and governance in Newfoundland and Victoria, reflect a collaborative, neoliberal, or business as usual (ad hoc, top down) approach. Based on such an assessment we consider the prospects for more integrated coastal zone management in each jurisdiction, as well as broader implications for governance and the resilience of coastal systems. It is argued that while both jurisdictions would benefit from a more collaborative approach, the mechanisms for bringing about such an approach would vary and will not come easily in light of institutional and historic barriers.

Cultural regionalism and environmental planning and design : charting regionalism in deference to globalism

The last 400 years has witnessed Western colonialism spread across the Asian communities and landscape transforming and re-defining their identity, culture, landscape patterns and meanings, as well as their land ethic. Whilst independence has brought forth robust attempts at nationalism it has been at the deference of regionalism and cultural identity. Instead, modernism, economic regeneration and growth, and attempts to define a nationalist image out of the newly created nations that are often a patchwork quilt of pre-colonial empires, are signalling the demise of critical regionalism and Indigenous knowledge systems. This paper considers the changes and cultural transformations over the last 400 years pointing to key dilemmas in regionalist growth, deterioration and stabilisation that are causing a loss of environmental and cultural values, morals and codes. These are the cultural and planning ‘rules’ that originally structured and guided the sustainable life and spirit of community, land and culture as an integrated whole. Particular attention will be drawn to the Indigenous communities of Malaysia, Indonesia and Australia that are struggling to maintain identity and environmental ethic in the shadow of major disjointed and multi-objectival national and international economic growth and digital transformation advances. Several possible answers or mediated strategies are offered, through a cultural heritage and planning lens, that could afford a respect and creative integration of these Indigenous knowledge systems to better inform regional growth and land management strategies so that it was regionally relevant.

Gender differences in recreational and transport cycling : a cross-sectional mixed-methods comparison of cycling patterns, motivators, and constraints

Background
Gender differences in cycling are well-documented. However, most analyses of gender differences make broad comparisons, with few studies modeling male and female cycling patterns separately for recreational and transport cycling. This modeling is important, in order to improve our efforts to promote cycling to women and men in countries like Australia with low rates of transport cycling. The main aim of this study was to examine gender differences in cycling patterns and in motivators and constraints to cycling, separately for recreational and transport cycling.

Methods
Adult members of a Queensland, Australia, community bicycling organization completed an online survey about their cycling patterns; cycling purposes; and personal, social and perceived environmental motivators and constraints (47% response rate). Closed and open-end questions were completed. Using the quantitative data, multivariable linear, logistic and ordinal regression models were used to examine associations between gender and cycling patterns, motivators and constraints. The qualitative data were thematically analyzed to expand upon the quantitative findings.

Results
In this sample of 1862 bicyclists, men were more likely than women to cycle for recreation and for transport, and they cycled for longer. Most transport cycling was for commuting, with men more likely than women to commute by bicycle. Men were more likely to cycle on-road, and women off-road. However, most men and women did not prefer to cycle on-road without designed bicycle lanes, and qualitative data indicated a strong preference by men and women for bicycle-only off-road paths. Both genders reported personal factors (health and enjoyment related) as motivators for cycling, although women were more likely to agree that other personal, social and environmental factors were also motivating. The main constraints for both genders and both cycling purposes were perceived environmental factors related to traffic conditions, motorist aggression and safety. Women, however, reported more constraints, and were more likely to report as constraints other environmental factors and personal factors.

Conclusion
Differences found in men’s and women’s cycling patterns, motivators and constraints should be considered in efforts to promote cycling, particularly in efforts to increase cycling for transport.