Comprehensive primary health care: a pathway to social inclusion and improved health

Originating from the World Health Organization of alma Ata in 1978, the philosophy of Comprehensive Primary Health Care (CPHC) includes the interconnecting principles of equity, access, empowerment, community self-determination and intersectoral collaboration in order to achieve better health outcomes for all people. It encompasses addressing the social, economic, cultural and political determinants of health. CPHC when implemented correctly should lead to social inclusion. However, implementing CPHC is complex due to misunderstandings about what it encompasses and about how to achieve the intended goals. This workshop aims to explore a range of issues that are tackled through a diverse range of primary health care services that target: community health, youth mental health, HIV/AIDS, homelessness, and marginalised disadvantaged groups.

The role of psychological and physiological factors in decision making under risk and in a dilemma

We study the difference in the result of two different risk elicitation methods by linking estimates of risk attitudes to gender, age, personality traits, a decision in a dilemma situation, and physiological states measured by heart rate variability (HRV). Our results indicate that differences between the methods can partly be explained by gender, but not by personality traits. Furthermore, HRV is linked to risktaking in the experiment for at least one of the methods, indicating that more stressed individuals display more risk aversion. Finally, we and that risk attitudes are not predictive of the ability to decide in a dilemma, but personality traits are. Surprisingly, there is also no apparent relationship between the physiological state during the dilemma situation and the ability to make a decision.

Design led innovation : shifting from smart follower to digital strategy leader in the Australian airport sector

This paper presents and discusses organisational barriers and opportunities arising from the dissemination of design led innovation within a leading Australian airport corporation. This research is part of a greater action research program which aims to integrate design as a strategic capability through design led innovation within Australian businesses. Findings reveal that there is an opportunity to employ the theoretical framework and tools of design led innovation in practice to build collaborative idea generation by involving customers and stakeholders within the proposal of new to world propositions. The iterative gathering of deep customer insights also provided an opportunity to leverage a greater understanding of stakeholders and customers in strengthening continuing business partnerships through co-design. Challenges to the design led approach include resistance to the exploratory nature of gathering deep customer insights, the testing of long held assumptions and market data, and the disruption of an organisational mindset geared toward risk aversion instilled within the aviation industry. The implication from these findings is that design led innovation can provide the critical platform to allow for a business to grow and sustain internal design capabilities necessary to challenge prevailing assumptions about how its business model operates to deliver value to customers and stakeholders alike. The platform of design led innovation also provides an avenue to support a cultural transformation towards anticipating future needs necessary for establishing a position of leadership within the broader economic environment.

Back to basics: Informing the public of co-morbid physical health problems in those with mental illness

Abstract OBJECTIVE: Those with mental illness are at increased risk of physical health problems. The current study aimed to examine the information available online to the Australian public about the increased risk and consequences of physical illness in those with mental health problems and the services available to address these co-morbidities. METHODS: A structured online search was conducted with the search engine Google Australia (www.google.com.au) using generic search terms 'mental health information Australia', 'mental illness information Australia', 'depression', 'anxiety', and 'psychosis'. The direct content of websites was examined for information on the physical co-morbidities of mental illness. All external links on high-profile websites [the first five websites retrieved under each search term (n = 25)] were examined for information pertaining to physical health. RESULTS: Only 4.2% of websites informing the public about mental health contained direct content information about the increased risk of physical co-morbidities. The Australian Government's Department of Health and Ageing site did not contain any information. Of the high-profile websites, 62% had external links to resources about physical health and 55% had recommendations or resources for physical health. Most recommendations were generic. CONCLUSIONS: Relative to the seriousness of this problem, there is a paucity of information available to the public about the increased physical health risks associated with mental illness. Improved public awareness is the starting point of addressing this health inequity.

Understanding causal relationships between the built and social environment, health and associated behaviours and risk factors

Introduction: Built environment interventions designed to reduce non-communicable diseases and health inequity, complement urban planning agendas focused on creating more ‘liveable’, compact, pedestrian-friendly, less automobile dependent and more socially inclusive cities.However, what constitutes a ‘liveable’ community is not well defined. Moreover, there appears to be a gap between the concept and delivery of ‘liveable’ communities. The recently funded NHMRC Centre of Research Excellence (CRE) in Healthy Liveable Communities established in early 2014, has defined ‘liveability’ from a social determinants of health perspective. Using purpose-designed multilevel longitudinal data sets, it addresses five themes that address key evidence-base gaps for building healthy and liveable communities. The CRE in Healthy Liveable Communities seeks to generate and exchange new knowledge about: 1) measurement of policy-relevant built environment features associated with leading non-communicable disease risk factors (physical activity, obesity) and health outcomes (cardiovascular disease, diabetes) and mental health; 2) causal relationships and thresholds for built environment interventions using data from longitudinal studies and natural experiments; 3) thresholds for built environment interventions; 4) economic benefits of built environment interventions designed to influence health and wellbeing outcomes; and 5) factors, tools, and interventions that facilitate the translation of research into policy and practice. This evidence is critical to inform future policy and practice in health, land use, and transport planning. Moreover, to ensure policy-relevance and facilitate research translation, the CRE in Healthy Liveable Communities builds upon ongoing, and has established new, multi-sector collaborations with national and state policy-makers and practitioners. The symposium will commence with a brief introduction to embed the research within an Australian health and urban planning context, as well as providing an overall outline of the CRE in Healthy Liveable Communities, its structure and team. Next, an overview of the five research themes will be presented. Following these presentations, the Discussant will consider the implications of the research and opportunities for translation and knowledge exchange. Theme 2 will establish whether and to what extent the neighbourhood environment (built and social) is causally related to physical and mental health and associated behaviours and risk factors. In particular, research conducted as part of this theme will use data from large-scale, longitudinal-multilevel studies (HABITAT, RESIDE, AusDiab) to examine relationships that meet causality criteria via statistical methods such as longitudinal mixed-effect and fixed-effect models, multilevel and structural equation models; analyse data on residential preferences to investigate confounding due to neighbourhood self-selection and to use measurement and analysis tools such as propensity score matching and ‘within-person’ change modelling to address confounding; analyse data about individual-level factors that might confound, mediate or modify relationships between the neighbourhood environment and health and well-being (e.g., psychosocial factors, knowledge, perceptions, attitudes, functional status), and; analyse data on both objective neighbourhood characteristics and residents’ perceptions of these objective features to more accurately assess the relative contribution of objective and perceptual factors to outcomes such as health and well-being, physical activity, active transport, obesity, and sedentary behaviour. At the completion of the Theme 2, we will have demonstrated and applied statistical methods appropriate for determining causality and generated evidence about causal relationships between the neighbourhood environment, health, and related outcomes. This will provide planners and policy makers with a more robust (valid and reliable) basis on which to design healthy communities.

Do good things and talk about them : a theory of academics usage of enterprise social networks for impression management tactics

Enterprise social networks provide benefits especially for knowledge-intensive work as they enable communication, collaboration and knowledge exchange. These platforms should therefore lead to increased adoption and use by knowledge-intensive workers such as consultants or indeed researchers. Our interest is in ascertaining whether scientific researchers use enterprise social networks as part of their work practices. This focus is motivated by an apparent schism between a need for researchers to exchange knowledge and profile themselves, and the aversion to sharing breakthrough ideas and joining in an ever-increasing publishing and marketing game. We draw on research on academic work practices and impression management to develop a model of academics’ ESN usage for impression management tactics. We describe important constructs of our model, offer strategies for their operationalization and give an outlook to our ongoing empirical study of the use of an ESN platform by 20 schools across six faculties at an Australian university.

Caribbean schooling and the social divide – what will it take to change neo-colonial education systems?

When Professor N’Dri Assie-Lumumba asked me to reflect on what ‘ubuntu’ might mean in the context of education in the Caribbean, the first thing that came to mind was an image of pit latrines in impoverished primary schools in poor countries. In this essay, I argue that the continuing problem of pit latrines in these schools symbolizes the failure to solve the problem of poverty, neglect and inadequate provision of education services for people at the bottom rungs of Caribbean and other decolonising societies. I ask what implications the ‘ubuntu’ concept chosen for the 2015 CIES conference would have for reforming education in a direction that combines global reform, ethics and good sense. Educators rarely consider toilets when they are thinking about what is needed to reform the system. But talking about toilets draws attention to the entrenched inequity that persists in education systems across the globe – an inequity that forces many schools and young people to remain at the base of the social pyramid, and that perpetuates a dysfunctional model of education holding back many societies. Starting from the twin images of social pyramids and toilets, we can ask some pointed questions about education reform.

Social policy implications relating to road trauma in a rapidly motorising world : the example of China

The World Health Organization (WHO) identifies road trauma as a major public health issue in all countries, though most notably among low-to-middle income countries and particularly those experiencing rapid motorisation, such as China. As China transitions from a nation of bicycle riders and pedestrians to one where car ownership is increasingly desired, there is need to address the accompanying social policy challenges. With this increased motorisation has come an increased road trauma burden, shouldered disproportionately among the population. Vulnerable road users (i.e., pedestrians, cyclists, motorcyclists) are of primary concern because they are most frequently killed in road crashes, representing approximately 70% of all Chinese road-related fatalities. The aim of this paper is to summarise the scale of the road trauma burden, highlight the disparity of this burden across the Chinese population, and discuss the related social policy implications in dealing with the impact of deaths and of otherwise healthy lives diminished by injury and disability. Future research priorities are also discussed and include the need to strive to provide detailed information on the level of inequity of the road trauma burden across the population and identify appropriate social supports and healthcare services required, both preventative and post-crash, so these can be developed and implemented throughout China.

The provision of visitable housing in Australia: Down to the detail

In response to the ratification of the United Nations Convention of the Rights of People with Disabilities (CRPD), Australian housing industry leaders, supported by the Australian Government, committed to transform their practices voluntarily through the adoption of a national guideline, called Livable Housing Design. They set a target in 2010 that all new housing would be visitable by 2020. Research in this area suggests that the anticipated voluntary transformation is unrealistic and that mandatory regulation will be necessary for any lasting transformation to occur. It also suggests that the assumptions underpinning the Livable Housing Design agreement are unfounded. This paper reports on a study that problematised these assumptions. The study used eleven newly-constructed dwellings in three housing contexts in Brisbane, Australia. It sought to understand the logics-of-practice in providing, and not providing, visitable housing. By examining the specific details that make a dwelling visitable, and interpreting the accounts of builders, designers and developers, the study identified three logics-of-practice which challenged the assumptions underpinning the Livable Housing Design agreement: focus on the point of sale; an aversion to change and deference to external regulators on matters of social inclusion. These were evident in all housing contexts indicating a dominant industry culture regardless of housing context or policy intention. The paper suggests that financial incentives for both the builder and the buyer, demonstration by industry leaders and, ultimately, national regulation is a possible pathway for the Livable Housing Design agreement to reach the 2020 goal. The paper concludes that the Australian Government has three options: to ignore its obligations under the CRPD; to revisit the Livable Housing Design agreement in the hope that it works; or to regulate the housing industry through the National Construction Code to ensure the 2020 target is reached.

When Japanese law goes pop

This article explores the extent to which the growth in law-themed popular culture since the turn of the century, especially television shows, signals a shift in popular attitudes towards law. Four decades of research into Japanese legal consciousness has called into question the extent to which there is a Japanese cultural aversion to Jaw, with most scholars expressing doubt over whether culture properly explains the comparatively low litigation rates in Japan compared to other industrialised nations. This article argues that popular culture, although not without its limitations, offers new clues into how legal consciousness is developing and changing in 21st Century Japan. The article concludes that popular culture paints a picture of a greater readiness by Japanese people to engage with Jaw, although scepticism remains about the law's promise to achieve justice and social solidarity.

The Art of Sympathy : Forms of Moral and Emotional Persuasion in Fiction

"The Art of Sympathy: Forms of Moral and Emotional Persuasion" in Fiction is an interdisciplinary study that looks closely at the ways that stories evoke sympathy, and the significance of this emotion for the development of moral attitudes and awareness. By linking readers' emotional responses to fiction with the potential impact of such responses on "the moral imagination," the study builds on empirical research conducted by literary scholars and psychologists into the emotional effects of reading fiction, as well as social psychological research into the connections between empathy/sympathy and moral development. I first investigate the dynamics of readers beliefs regarding characters in fictional narratives, and the nature of the emotions that they may experience as a result of those beliefs. The analysis demonstrates that there are important similarities between real emotions and emotions generated by fiction. Recognizing these similarities, I claim, can help us to conceptualize the nature of sympathetic responses to fictional characters. Building on these assertions, I then draw on research from social psychology and philosophy to develop a comprehensive definition of sympathy and to clarify the ways in which sympathy operates, both in people s daily lives and in readers sympathetic responses to fictional characters. Having established this definition and delineated its practical implications, I then examine how particular stories, through a variety of narrative techniques, persuade readers to feel sympathy for characters who are unsympathetic in certain ways. In order to verify my claims about the impact of these stories on readers emotions, I also review the results of tests that I conducted with nearly 200 adolescent readers. Through these tests, which were constructed and scored according to methods prevalent in social psychological research, it was determined that a majority of readers felt sympathy for the protagonists in two of the stories included in the study. These results were combined with data from an additional test, a standard measure of empathy and sympathy in the field of social psychology. The cross-tabulation of these results suggests that there was not a strong connection between readers responses and their general tendencies to feel sympathy for others. This finding would appear to support my hypotheses regarding the sympathetic persuasiveness of the stories in question. In light of these results, finally, I consider the potential contribution that fiction can make to adolescent emotional and moral development and the implications of that potential for future language arts curricula in the schools. In particular, I suggest the pedagogical importance of providing adolescents with opportunities to engage with the lives of fictional characters, and especially to experience feelings of sympathy for individuals towards whom they ordinarily might feel aversion.

An experimental analysis of information acquisition in prediction markets

We study which factors in terms of trading environment and trader characteristics determine individual information acquisition in experimental asset markets. Traders with larger endowments, existing inconclusive information, lower risk aversion, and less experience in financial markets tend to acquire more information. Overall, we find that traders overacquire information, so that informed traders on average obtain negative profits net of information costs. Information acquisition and the associated losses do not diminish over time. This overacquisition phenomenon is inconsistent with predictions of rational expectations equilibrium, and we argue it resembles the overdissipation results from the contest literature. We find that more acquired information in the market leads to smaller differences between fundamental asset values and prices. Thus, the overacquisition phenomenon is a novel explanation for the high forecasting accuracy of prediction markets.

Persistence of sodium monofluoroacetate (1080) in fox baits and implications for fox management in south-eastern Australia

The persistence of 1080 in two commonly used fox baits, Foxoff ® and chicken wingettes, was assessed under different climatic and rainfall conditions in central-western New South Wales. The rate of 1080 degradation did not change significantly between the Central Tablelands and the relatively hotter and drier environment of the Western Slopes. Loss of 1080 from wingettes was independent of the rainfall and climate conditions, with wingettes remaining lethal to foxes for, on average, 0.9 weeks. Foxoff ® baits remained lethal for longer than wingettes under all tested conditions, although their rate of degradation increased generally with increasing rainfall. As a result, areas baited with Foxoff® will require longer withholding periods for working dogs than those baited with wingettes, especially during dry periods. Wingettes may have advantages for use in sensitive areas where long-term hazards from toxic baits are undesirable. We found significant variations in 1080 concentration in freshly prepared baits that may result in efficacy, non-target and regulatory concerns for baiting campaigns. As a result, the superior quality control and shelf-stability of manufactured Foxoff® may be important criteria for favouring its use over freshly prepared bait types. However, use strategies for any bait type must ensure that foxes consume lethal doses of 1080 to avoid potential problems such as the development of learned aversion to baits or pesticide resistance.

A Comparison of the Implementation of the Employment Provisions of the Americans with Disabilities Act of 1990 (ADA) in the United States and the Disability Discrimination Act (DDA) 1995 in the United Kingdom

This summarizes the results of recently conducted surveys in the United States and Britain to assess employer response in each of these countries to their respective employment disability nondiscrimination legislation.