Assessing Cardiovascular Risk in Regional Areas: The Healthy Hearts – Beyond City Limits Program

Background: Cardiovascular disease (CVD) is more prevalent in regional and remote Australia compared to metropolitan areas. The aim of Healthy Hearts was to determine age and sex specific CVD risk factor levels and the potential value of national risk clinics. Methods: Healthy Hearts was an observational research study conducted in four purposefully selected higher risk communities in regional Victoria, Australia. The main outcome measures were the proportion of participants with CVD risk factors with group comparisons to determine the adjusted likelihood of elevated risk factor levels. Trained personnel used a standardized protocol over four weeks per community to measure CVD risk factor levels, estimate absolute CVD risk and provide feedback and advice. Results: A total of 2125 self-selected participants were assessed (mean age 58 ± 15 years, 57% women). Overall, CVD risk factors were highly prevalent. More men than women had ≥ 2 modifiable CVD risk factors (76% vs. 68%, p < .001), pre-existing CVD (20 vs. 15%, p < .01) and a major ECG abnormality requiring follow-up (15% vs. 7%, p < .001) . Less men reported depressive symptoms compared to women (28% vs. 22%, p < .01). A higher proportion of women were obese (adjusted OR 1.36, 95% CI 1.13 to 1.63), and physically inactive (adjusted OR 1.32, 95% CI 1.07 to 1.63). Conclusions: High CVD risk factor levels were confirmed for regional Victoria. Close engagement with individuals and communities provides scope for the application of regional risk management clinics to reduce the burden of CVD risk in regional Australia.

Intravascular device-related research : future priority areas for cancer nursing

The majority of cancer nurses have to manage intravascular devices (IVDs) on a daily basis, thus placing nurses in the strongest position to generate and use best available evidence to inform this area of practice and to ensure that patients are receiving the best care available. Our literature clearly reflects that cancer nurses are concerned about complications associated with IVDs (eg, extravasation,1 IVD-related bloodstream infection [IVD-BSI],2,3 and thrombosis4). Although enormous attention is given to this area, a number of nursing practices are not sufficiently based on empirical evidence.5,6 Nurses need to set goals and priorities for future research and investments. Priority areas for future research are suggested here for your consideration.

Responding to national curriculum goals for English language learners : enhancing reading strategies in high school content areas

The official need for content teachers to teach the language features of their fields has never been greater in Australia than now. In 2012, the recently formed national curriculum board announced that all teachers are responsible for the English language development of students whose first language or dialect is not Standard Australian English (SAE). This formal endorsement is an important juncture regarding the way expertise might be developed, perceived and exchanged between content and language teachers through collaboration, in order for the goals of English language learners in content areas to be realised. To that end, we conducted an action research project to explore and extend the reading strategies pedagogy of one English language teacher who teaches English language learners in a parallel junior high school Geography program. Such pedagogy will be valuable for all teachers as they seek to contribute to English language development goals as outlined in national curricula.

Consumer product-related injuries in Queensland children : A snapshot of current problem areas for potential action

This report presents a snapshot from work which was funded by the Queensland Injury Prevention Council in 2010-11 titled “Feasibility of Using Health Data Sources to Inform Product Safety Surveillance in Queensland children”. The project provided an evaluation of the current available evidence-base for identification and surveillance of product-related injuries in children in Queensland and Australia. A comprehensive 300 page report was produced (available at: http://eprints.qut.edu.au/46518/) and a series of recommendations were made which proposed: improvements in the product safety data system, increased utilisation of health data for proactive and reactive surveillance, enhanced collaboration between the health sector and the product safety sector, and improved ability of health data to meet the needs of product safety surveillance. At the conclusion of the project, a Consumer Product Injury Research Advisory group (CPIRAG) was established as a working party to the Queensland Injury Prevention Council (QIPC), to prioritise and advance these recommendations and to work collaboratively with key stakeholders to promote the role of injury data to support product safety policy decisions at the Queensland and national level. This group continues to meet monthly and is comprised of the organisations represented on the second page of this report. One of the key priorities of the CPIRAG group for 2012 was to produce a snapshot report to highlight problem areas for potential action arising out of the larger report. Subsequent funding to write this snapshot report was provided by the Institute for Health and Biomedical Innovation, Injury Prevention and Rehabilitation Domain at QUT in 2012. This work was undertaken by Dr Kirsten McKenzie and researchers from QUT's Centre for Accident Research and Road Safety - Queensland. This snapshot report provides an evidence base for potential further action on a range of children’s products that are significantly represented in injury data. Further information regarding injury hazards, safety advice and regulatory responses are available on the Office of Fair Trading (OFT) Queensland website and the Product Safety Australia websites. Links to these resources are provided for each product reviewed.

Characterisation of atmospheric deposited particles during a dust storm in urban areas of Eastern Australia

The characteristics of dust particles deposited during the 2009 dust storm in the Gold Coast and Brisbane regions of Australia are discussed in this paper. The study outcomes provide important knowledge in relation to the potential impacts of dust storm related pollution on ecosystem health in the context that the frequency of dust storms is predicted to increase due to anthropogenic desert surface modifications and climate change impacts. The investigated dust storm contributed a large fraction of fine particles to the environment with an increased amount of total suspended solids, compared to dry deposition under ambient conditions. Although the dust storm passed over forested areas, the organic carbon content in the dust was relatively low. The primary metals present in the dust storm deposition were aluminium, iron and manganese, which are common soil minerals in Australia. The dust storm deposition did not contain significant loads of nickel, cadmium, copper and lead, which are commonly present in the urban environment. Furthermore, the comparison between the ambient and dust storm chromium and zinc loads suggested that these metals were contributed to the dust storm by local anthropogenic sources. The potential ecosystem health impacts of the 2009 dust storm include, increased fine solids deposition on ground surfaces resulting in an enhanced capacity to adsorb toxic pollutants as well as increased aluminium, iron and manganese loads. In contrast, the ecosystem health impacts related to organic carbon and other metals from dust storm atmospheric deposition are not considered to be significant.

Improving the Walkability of Subtropical Urban Areas: a case study analysis for the development of a design process

This research develops a new framework to be used as a tool for analysing and designing walkable communities. The literature review recognises the work of other researchers combining their findings with the theory of activity nodes and considers how a framework may be used on a more global basis. The methodology develops a set of criteria through the analysis of noted successful case studies and this is then tested against an area with very low walking rates in Brisbane, Australia. Results of the study suggest that as well as the accepted criteria of connectivity, accessibility, safety, security, and path quality further criteria in the form or planning hierarchy, activity nodes and climate mitigation could be added to allow the framework to cover a broader context. Of particular note is the development of the nodal approach, which allows simple and effective analysis of existing conditions, and may also prove effective as a tool for planning and design of walkable communities.

Review : "Heat islands : understanding and mitigating heat in urban areas" by Lisa Gartland. Reviewed by Tony Matthews.

Heat islands are a significant problem in urban spaces worldwide. The phenomenon occurs when air and surface temperatures in urban areas significantly exceed those experienced in nearby rural areas. There are two main causes of heat islands. The first is the use of highly absorptive construction materials in buildings and infrastructure, which soak up heat and radiate it back into the immediate surroundings. These materials, including but not limited to concrete, steel, asphalt and stone, are usually impermeable and so do not embody moisture that could dissipate some of the absorbed heat. The second cause relates to urban form, where the canyon-like configurations of buildings and streets channel and trap heat from the sun. In both cases, an absence of greenery and other soft landscaping can compound the problem by lowering capacity for cooling through shading and evotranspiration. Incidences of heat islands increase as urban areas swell in size and cover more land area, making the phenomenon an unwelcome side effect of global trends towards increased urbanisation. Heat islands create serious problems, including increased energy demand for cooling, declining air quality and heat stress for people and animals. In very severe cases, heat islands can compound the effects of high urban temperatures, leading to increased human mortality...

Context matters : Violence against women and reporting to police in rural, suburban and urban areas

Despite plentiful efforts to identify perpetrator, victim, and incident characteristics correlated with reporting violence against women to police, few studies have addressed the contexts that shape such reporting. Even fewer have examined variations in these contexts across geographic areas. Drawing upon National Crime Victimization Survey data from 1992 through 2009, this paper uses conjunctive analysis of case configurations to identify and investigate the dominant situational contexts of reporting of violence against women to police across rural, suburban, and urban areas. Our findings show that context matters and the importance of incident, perpetrator, and victim characteristics vary across geographic areas.

Towards an appropriate fatigue loading sequence for roof claddings in cyclone prone areas

Currently two different fatigue tests are being used to investigate the fatigue susceptibility of roof claddings in the cyclone prone areas of Australia. In order to resolve this issue a detailed investigation was conducted to study the nature of cyclonic wind forces using wind tunnel testing and computer modelling and the fatigue behaviour of metal roof claddings using structural testing. This led to the development of an accurate, but complicated loading matrix for a design cyclone. Based on this matrix, a simplified low-high-low loading sequence has been developed for the testing of roofing systems in cyclone prone areas. This paper first reviews the currently used fatigue loading sequences, then presents details of the cyclonic wind loading matrix and finally the development of the new simplified loading sequence. This simplified sequence should become the only suitable test for most of the cyclone prone areas of Australia covered by Region C which suffers from Category 4 cyclones. For Region D which suffers from Category 5 cyclones, the same loading sequence with 20% increased cycles has been recommended. An experimental programme to validate the new simplified loading sequence has been proposed.

A review of the educational needs of nurses administering cancer chemotherapy in rural and remote areas of Queensland

This paper describes current issues in chemotherapy nursing practice in rural and remote Australia. There is a trend to refer chemotherapy clients back to their rural and remote health facility for treatment from major oncology centres in Australia. However, it is increasingly apparent that the majority of nurses administering chemotherapy in smaller centres lack the theoretical and clinical knowledge to ensure optimum client outcomes and nurse/client safety. There are also issues unique to rural and remote life which will influence optimum chemotherapy service delivery. The research program described in the paper will ascertain the education requirements of rural and remote nurses administering chemotherapy and the design and delivery of a chemotherapy education package specific to the rural and remote context. Similar programs will ensure the best standards of chemotherapy practice in non-metropolitan areas by enhancing the practical and theoretical knowledge base of rural and remote nurses.

People living in hilly residential areas in metropolitan Perth have less diabetes : spurious association or important environmental determinant?

BACKGROUND: Variations in 'slope' (how steep or flat the ground is) may be good for health. As walking up hills is a physiologically vigorous physical activity and can contribute to weight control, greater neighbourhood slopes may provide a protective barrier to weight gain, and help prevent Type 2 diabetes onset. We explored whether living in 'hilly' neighbourhoods was associated with diabetes prevalence among the Australian adult population. METHODS: Participants ([greater than or equal to]25years; n=11,406) who completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) were asked whether or not they had medically-diagnosed diabetes. Geographic Information Systems (GIS) software was used to calculate a neighbourhood mean slope score, and other built environment measures at 1600m around each participant's home. Logistic regression models were used to predict the odds of self-reported diabetes after progressive adjustment for individual measures (i.e., age, sex), socioeconomic status (i.e., education, income), built environment, destinations, nutrition, and amount of walking. RESULTS: After full adjustment, the odds of self-reported diabetes was 0.72 (95% CI 0.55-0.95) and 0.52 (95% CI 0.39-0.69) for adults living in neighbourhoods with moderate and higher levels of slope, respectively, compared with adults living in neighbourhoods with the lowest levels of slope. The odds of having diabetes was 13% lower (odds ratio 0.87; 95% CI 0.80-0.94) for each increase of one percent in mean slope. CONCLUSIONS: Living in a hilly neighbourhood may be protective of diabetes onset or this finding is spurious. Nevertheless, the results are promising and have implications for future research and the practice of flattening land in new housing developments.