Letter – Author Reply

Our finding that one in five respondents (22.6%) said they would cycle more if they didn't have to wear helmets is significant, because if even half these people did cycle more, it could substantially increase the prevalence of cycling. For Olivier et al. to challenge that bicycle helmet legislation is a barrier to more people cycling is counter to all the available evidence. As stated in our article,1 when legislation was introduced in Australia cycling levels fell by 30–40%, and the same phenomenon was observed in New Zealand in 1994. A recent national survey found one in six people reported helmets as a barrier to more cycling.     

A critical review of simulation‐based medical education research: 2003–2009

Objectives This article reviews and critically evaluates historical and contemporary research on simulation‐based medical education (SBME). It also presents and discusses 12 features and best practices of SBME that teachers should know in order to use medical simulation technology to maximum educational benefit. Methods This qualitative synthesis of SBME research and scholarship was carried out in two stages. Firstly, we summarised the results of three SBME research reviews covering the years 1969–2003. Secondly, we performed a selective, critical review of SBME research and scholarship published during 2003–2009. Results The historical and contemporary research synthesis is reported to inform the medical education community about 12 features and best practices of SBME: (i) feedback; (ii) deliberate practice; (iii) curriculum integration; (iv) outcome measurement; (v) simulation fidelity; (vi) skill acquisition and maintenance; (vii) mastery learning; (viii) transfer to practice; (ix) team training; (x) high‐stakes testing; (xi) instructor training, and (xii) educational and professional context. Each of these is discussed in the light of available evidence. The scientific quality of contemporary SBME research is much improved compared with the historical record. Conclusions Development of and research into SBME have grown and matured over the past 40 years on substantive and methodological grounds. We believe the impact and educational utility of SBME are likely to increase in the future. More thematic programmes of research are needed. Simulation‐based medical education is a complex service intervention that needs to be planned and practised with attention to organisational contexts. Medical Education 2010: 44 : 50–63     

Understanding the metabolome – challenges for metabolomics

Metabolomics is a comprehensive method for metabolite assessment, measuring the overall metabolic signature of biological samples. This approach opens up many possibilities in areas such as new biomarker discovery and hypothesis generation. The application of metabolomics is growing rapidly but many challenges must first be addressed before it can reach its true potential. Metabolomics organisations are currently working towards guidelines for commonality in metabolomics experiments as development of optimal methodologies and study designs are needed. Blood and urine appear to be the most useful biofluids for nutrition research, but an array of biofluids, cells and tissues can be used. The key steps required for the successful understanding of metabolomics data are compound identification and biological interpretation. Many databases of compounds are available but are still under construction with much information remaining to be populated. An understanding of the effects of normal physiological variation on metabolic profiles is essential for accurate interpretation of profile changes, particularly in human studies, because of diversity in lifestyle and environmental factors. The effects of factors such as ethnicity, gender, age, body composition, health, dietary intake, physical activity, gut microflora and stress need to be further explored in order to advance the understanding of the human metabolome and therefore improve data interpretation.     

Letter – Locational variation in adolescents' concerns over ‘body image’

Introduction: A statewide study of New South Wales (NSW) adolescents' health concerns was conducted in 2001/02. The data on adolescents consisted of 81 focus groups, 56 urban and 22 rural/3 regional areas of NSW. One issue, ‘body image’, was a raised by adolescents in both urban and rural/regional locations, but in twice as many beach (coastal) than inland locations and often expressed in a more extreme way.     

Editorial – Tapping the potential of research‐based advocacy

The value of both policy‐relevant research and evidence‐informed policy in public health and health promotion is well documented. Interestingly, research‐based policy advocacy is one arena in which these approaches become very directly and immediately linked. Research‐based advocacy for policy has been a powerful force in tobacco control and is building momentum in some aspects of alcohol policy. There is also a rising current of policy‐directed advocacy to redress obesity‐promoting social and environmental factors, including food marketing to children, food labelling and active living environments. As one of health promotion's most powerful tools, research‐based advocacy encapsulates many of the strengths of health promotion. It draws upon specialised research skills and links them with public communication methods. Importantly, it is guided by clear goals and a vision of an environment and society that protects and values people's well‐being. Both the research and the communication activities that characterise advocacy seek to spotlight aspects of society that may be taken for granted, but which work against people's interests; they can provide a focused and organised examination of what is going on and promote the alternatives as feasible policy options.     

Contraceptive knowledge and attitudes among 14–24‐year‐olds in New South Wales,Australia

Objectives: To investigate correlates of contraceptive knowledge and attitudes and describe differences in contraceptive knowledge by contraceptive category among young people in New South Wales. Methods: A total of 119 young people aged 14 to 24, recruited from youth centres, completed a contraceptive knowledge and attitude survey. Results: Overall contraceptive knowledge was low. Females had significantly better knowledge than males. There was high knowledge about condoms and withdrawal and low knowledge about shorter‐term hormonal methods (oral contraceptive pill and vaginal ring) and long‐acting reversible contraceptive (LARC) methods. Nearly half of respondents agreed that ‘contraceptives make sex seem less romantic’, while 58% agreed that ‘contraceptives are difficult to use’. Despite this, both genders had positive attitudes to contraception, with females’ attitudes significantly more positive than males. Conclusions and implications: While young people, particularly young women, expressed attitudes conducive to contraceptive use, many are unaware of basic facts about methods, including highly effective LARC. Our findings reflect the modest reproductive and sexual health education received by Australian young people and cultural norms of condoms and oral contraceptives as default methods and highlight the need to improve knowledge, among young men, in particular, about the most effective contraceptive methods.     

Letter – Capacity building for evaluation of social connectedness

There is an increasing body of work addressing the health priority of social connectedness, but published evaluations remain limited. Evaluation evidence is important for informing health promotion practice, and a need to improve health promotion practitioners' evaluation capacity has been identified.     

Child obesity prevalence across communities in New Zealand: 2010–2016

Objective : To assess community‐level differences in four‐year‐old obesity prevalence in New Zealand (NZ), trends over time, and the extent to which differences can be explained by ethnicity, deprivation and urbanicity. Methods: Obesity measures from the Ministry of Health’s B4 School Check were available for 72–92% of NZ four‐year‐olds for fiscal years 2010/11–2015/16. Ethnicity, deprivation and urbanicity data for the 78 communities were obtained by linking to administrative records. Growth models were used to examine variability in obesity levels and trends over time, and the extent to which ethnicity, deprivation and urbanicity contributed to differences between communities. Results : There were large variations in obesity across communities (range 8.4% to 28.8%). A decline in the prevalence of childhood obesity was observed in most (48 of 78) communities from 2010/11 to 2015/16 (average change=0.2%, range=‐2.0% to 1.9%). Around 50% of the variance in obesity between territorial authorities could be explained by differences in socioeconomic deprivation and ethnic composition. Conclusions : Child obesity varies between NZ communities, but most territorial authorities have experienced a decrease in obesity over the period 2010/11–2015/16. Implications for public health : Addressing deprivation and ethnic inequalities in obesity could substantially reduce community‐level differences in obesity in NZ.     

Letter – Community perceptions of smoking bans in NSW licensed venues

Environmental tobacco smoke increases the risk of lung cancer and coronary heart disease, as well as causing irritation to the eyes, nose and throat. In recent years it has become clear that the only way to protect non‐smokers from exposure to environmental tobacco smoke in indoor areas is by eliminating smoking in those areas. In 2004 the New South Wales (NSW) Government announced that smoking in the indoor areas of licensed premises would be phased out by July 2007. The reason for this decision was to protect workers and patrons in these venues from the detrimental health effects of prolonged exposure to environmental tobacco smoke. At the same time, NSW Health conducted a study to monitor community attitudes to the phased introduction of smoking bans in these venues between 2003 and 2007 to gauge public understanding and acceptance of the government action and inform policy roll out. In combination with other data these surveys provide a powerful tool for health policy development.     

Letter – Closing the ‘Targets’ Gaps: Review of 2008–2030 National Indigenous Health Equality Targets

While the 2008 National Indigenous Health Equality Targets (‘Close the Gap’) has received strong support at federal, state and territory government levels as well as among many Indigenous groups, medical associations and civil society groups, it has secured only cautious support from some Indigenous health researchers and policy analysts. We agree with the need for caution and posit that the document could be improved in a number of areas.