The new work order: ensuring young Australians have skills and experience for the jobs of the future, not the past

Economic changes are transforming work through automation, globalisation, and more flexible work. Overview Work has long been important for the livelihood, dignity, and happiness of humankind. We intuitively and statistically know that work helps us meet our most basic and complex needs, providing a path towards financial security, mental and physical health, dignity and meaning. For at least the past century, the prospect of a good job that pays a fair wage has been part of Australia’s promise to our young people. By many measures, Australia has continued to deliver on its promise. We have enjoyed relatively strong economic growth, high wages and low levels of unemployment. But beneath the seemingly benign surface of Australia’s labour market, there is a quiet revolution occurring in the way we work. The old ‘blue collar’ part of workforce is barely recognisable today. As the factories in our urban manufacturing suburbs have been closed down or automated, the manual jobs they once provided have been decimated. Over the past 25 years, we have lost around 100,000 machinery operator jobs, nearly 400,000 labourers, and nearly 250,000 jobs from the technicians and trades. Offsetting these losses, there has been an explosion of more than 400,000 new jobs in community and personal services. The work revolution is no less visible in what we used to call ‘white collar’ jobs. Computers have swept through corporate towers and small business offices, displacing nearly 500,000 secretaries and clerks. At the same time, the increasing complexity of business processes and financial markets has created 700,000 new jobs across the professional and business services. While our unemployment rate may be low, our factory floor workers have not seamlessly switched their hard hats for a healthcare job. Instead, unskilled workers, especially men, have stepped out of the labour force on mass. Over the past 25 years, nearly one in ten unskilled men lost their jobs and did not return to the labour force. Today, more than one in four unskilled men don’t participate. Big economic shifts are not costless for everyone

Effect of a reduction in glomerular filtration rate after nephrectomy on arterial stiffness and central hemodynamics: rationale and design of the EARNEST study

Background: There is strong evidence of an association between chronic kidney disease (CKD) and cardiovascular disease. To date, however, proof that a reduction in glomerular filtration rate (GFR) is a causative factor in cardiovascular disease is lacking. Kidney donors comprise a highly screened population without risk factors such as diabetes and inflammation, which invariably confound the association between CKD and cardiovascular disease. There is strong evidence that increased arterial stiffness and left ventricular hypertrophy and fibrosis, rather than atherosclerotic disease, mediate the adverse cardiovascular effects of CKD. The expanding practice of live kidney donation provides a unique opportunity to study the cardiovascular effects of an isolated reduction in GFR in a prospective fashion. At the same time, the proposed study will address ongoing safety concerns that persist because most longitudinal outcome studies have been undertaken at single centers and compared donor cohorts with an inappropriately selected control group.<p></p> Hypotheses: The reduction in GFR accompanying uninephrectomy causes (1) a pressure-independent increase in aortic stiffness (aortic pulse wave velocity) and (2) an increase in peripheral and central blood pressure.<p></p> Methods: This is a prospective, multicenter, longitudinal, parallel group study of 440 living kidney donors and 440 healthy controls. All controls will be eligible for living kidney donation using current UK transplant criteria. Investigations will be performed at baseline and repeated at 12 months in the first instance. These include measurement of arterial stiffness using applanation tonometry to determine pulse wave velocity and pulse wave analysis, office blood pressure, 24-hour ambulatory blood pressure monitoring, and a series of biomarkers for cardiovascular and bone mineral disease.<p></p> Conclusions: These data will prove valuable by characterizing the direction of causality between cardiovascular and renal disease. This should help inform whether targeting reduced GFR alongside more traditional cardiovascular risk factors is warranted. In addition, this study will contribute important safety data on living kidney donors by providing a longitudinal assessment of well-validated surrogate markers of cardiovascular disease, namely, blood pressure and arterial stiffness. If any adverse effects are detected, these may be potentially reversed with the early introduction of targeted therapy. This should ensure that kidney donors do not come to long-term harm and thereby preserve the ongoing expansion of the living donor transplant program.<p></p&gt

Sustainable supply chain management in tourism

Sustainable supply chain management (SSCM) encapsulates the trend to use purchasing policies and practices to facilitate sustainable development at the tourist destination. Most research has focused on environmental aspects of manufacturing, while other aspects of sustainability or the challenges for the service sector are largely ignored. Yet SSCM is particularly important for tour operators, as the product depends on the activities of suppliers, such as accommodation, transport and activities. Therefore, tour operators' contribution to sustainable tourism will be more effective through the definition and implementation of policies that acknowledge responsibility for the impacts of suppliers. Exploratory research of SSCM practices amongst tour operators generated a wide range of examples of good practice across the whole supply chain, and recommendations are made for more widespread engagement. Copyright © 2006 John Wiley & Sons, Ltd and ERP Environment

Emotion regulation styles as longitudinal predictors of compulsive exercise : a twelve month prospective study

Exercise can be used as a mood regulator but, in the eating disorder literature, exercise has sometimes been found to be compulsive, detrimental to physical health, and regarded as one maladaptive strategy used to regulate emotions. This study examined longitudinal associations between emotion regulation styles and this compulsive exercise in 572 adolescents who completed measures of compulsive exercise and emotion regulation. Twelve months later they completed measures of compulsive exercise. Compulsive exercise was predicted by Internal Dysfunctional emotion regulation in girls and boys, even after controlling for initial levels of compulsive exercise. Adolescents displaying compulsivity to exercise may require intervention programmes to alter their emotion regulation strategies

Walking to School: Incidental Physical Activity in the Daily Occupations of Australian Children

Children's participation in physical activity is declining, and nowhere is this more apparent than in the incidental activity of walking to school_ The aim of this pilot study was to examine the extent to which Australian children walked to and from primary school, and to survey parents to identify factors influencing this behaviour. Parents of 164 students in Grades I-7 (mean age 9.1 +/- 2.02 years) from a primary school comprising 360 students responded to a questionnaire regarding psychosocial and environmental factors thought to influence the means by which their children went to and from school. Results indicated that parent perception of the importance of physical activity, parents' individual history of transport to school as well as distance from school were the most statistically significant factors determining children's involvement in walking to and from school. The results of this study highlight the attitudes and experiences of parents in determining the extent to which children are involved in non-motorized access to school. Also implicated are organizational policies about geographical school regions. While this study is limited to one school community, further study is recommended with others to better confirm findings by examining socioeconomic, geographic and policy variables. Occupational therapists are challenged to examine ways in which incidental physical activity can be increased in the lives of young children

Social justice and out-of-school science learning: Exploring equity in science television, science clubs and maker spaces

We cannot take access to equitable out-of-school science learning for granted. Data compiled in 2012 show that between a fifth (22% in Brazil) and half (52% in China and the United States) of people in China, Japan, South Korea, India, Malaysia, the United States, the European Union, and Brazil visited zoos, aquaria, and science museums (National Science Foundation, 2012). But research suggests participation in out-of-school science learning is far from equitable and is marked by advantage, not least the social axes of age, social class, and ethnicity (Dawson, 2014a, 2014b; National Science Foundation, 2012; OECD, 2012). For instance, in the UK data suggest that the two-thirds of the population who took part in out-of-school science learning activities1 in the previous year were more affluent (upper and middle classes) and from the White ethnic majority (Ipsos MORI, 2014). If we believe that out-of-school science learning provides valuable educational, cultural, social and political opportunities, then we must take questions of equity seriously. Ideas from social justice can help us understand how equity issues are woven through out-of-school science learning practices. In this paper, I outline how social justice theories, in combination with the concepts of infrastructure access, literacies and community acceptance, can be used to think about equity in out-of-school science learning. I apply these ideas to out-of-school science learning via television, science clubs and maker spaces, looking at research as well as illustrative examples to see how equity challenges are being addressed in practice. I argue that out-of-school science learning practices can be understood on a spectrum from weak to strong models of social justice. Thinking about social justice as a spectrum helps us think through what equitable out-of-school science learning practices might involve, both to analyze existing practices and, importantly, to imagine new, more inclusive ones. Out-of-school science learning is a broad term, used to describe quite different activities, participants, aims, and practices. It can mean enjoying science festivals, watching science documentaries, pursing science-related hobbies as well as activities focused on engineering, mathematics, or technology (see, e.g., Bonney et al., 2009; Dingwall & Aldridge, 2006; Kaiser, Durant, Levenson, Wiehe, & Linett, 2013). In this paper, I focus primarily on the contrasting worlds of television and science clubs as out-of-school science learning contexts2. I use “science” as an umbrella term for science, technology, engineering, or mathematics related subjects. However, I add a caveat to how I use the term out-of-school. Because “out-of-school” invokes the idea of school, there can be a tendency to focus on youth as participants and activities that are for, by, or with youth. But of course adults may not consider their television watching an “out-of-school” activity. Thus, I note here that I keep both adults and youth in mind when writing about equity and out-of-school science learning

The sacred and the profane: biotechnology, rationality, and public debate

Davies G, 2006. The definitive, peer-reviewed and edited version of this article is published in Environment and Planning A, 38(3), pp. 423 – 443 DOI: 10.1068/a37387This paper explores the forms of argumentation employed by participants in a recent public engagement process in the United Kingdom around new technologies for organ transplantation, with specific reference to xenotransplantation and stem-cell research. Two forms of reasoning recur throughout participants’ deliberations which challenge specialist framing of this issue. First, an often scatological humour and sense of the profane are evident in the ways in which participants discuss the bodily transformations that such technologies demand. Second, a sense of the sacred, in which new biotechnologies are viewed as against nature or in which commercial companies are ‘playing god’, is a repetitive and well-recognised concern. Such forms of reasoning are frequently dismissed by policymakers as ‘uninformed gut reactions’. Yet they also form a significant part of the repertoire of scientists themselves as they proclaim the hope of new medical breakthroughs, or seek to reconstruct ideas of the body to facilitate new biotechnological transformations. Through questioning of assumptions in Habermas’s notion of discourse ethics, and exploring the importance of hybridity and corporeality as concepts in ethical thinking, the author suggests that, far from being ill-formed opinions, such reasonings perform an important function for thinking through the ontological significance of the corporealisation of these proposed new forms of human and animal bodies

Comparison of active treatments for impaired glucose regulation : a Salford Royal Foundation Trust and Hitachi collaboration (CATFISH): study protocol for a randomized controlled trial

BACKGROUND: Diabetes is highly prevalent and contributes to significant morbidity and mortality worldwide. Behaviour change interventions that target health and lifestyle factors associated with the onset of diabetes can delay progression to diabetes, but many approaches rely on intensive one-to-one contact by specialists. Health coaching is an approach based on motivational interviewing that can potentially deliver behaviour change interventions by non-specialists at a larger scale. This trial protocol describes a randomized controlled trial (CATFISH) that tests whether a web-enhanced telephone health coaching intervention (IGR3) is more acceptable and efficient than a telephone-only health coaching intervention (IGR2) for people with prediabetes (impaired glucose regulation). METHODS: CATFISH is a two-parallel group, single-centre individually randomized controlled trial. Eligible participants are patients aged ≥18 years with impaired glucose regulation (HbA1c concentration between 42 and 47 mmol/mol), have access to a telephone and home internet and have been referred to an existing telephone health coaching service at Salford Royal NHS Foundation Trust, Salford, UK. Participants who give written informed consent will be randomized remotely (via a clinical trials unit) to either the existing pathway (IGR2) or the new web-enhanced pathway (IGR3) for 9 months. The primary outcome measure is patient acceptability at 9 months, determined using the Client Satisfaction Questionnaire. Secondary outcome measures at 9 months are: cost of delivery of IGR2 and IGR3, mental health, quality of life, patient activation, self-management, weight (kg), HbA1c concentration, and body mass index. All outcome measures will be analyzed on an intention-to-treat basis. A qualitative process evaluation will explore the experiences of participants and providers with a focus on understanding usability of interventions, mechanisms of behaviour change, and impact of context on delivery and user acceptability. Qualitative data will be analyzed using Framework. DISCUSSION: The CATFISH trial will provide a pragmatic assessment of whether a web-based information technology platform can enhance acceptability of a telephone health coaching intervention for people with prediabetes. The data will prove critical in understanding the role of web applications to improve engagement with evidence-based approaches to preventing diabetes. TRIAL REGISTRATION: ISRCTN16534814 . Registered on 7 February 2016

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder:a mixed-methods approach

BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this. ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users. MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme. ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total; p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78; p < 0.006). ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted. FundingThe National Institute for Health Research Programme Grants for Applied Research programme