The Social Determinants of Health: Time to Re-Think?

Twelve years have now passed since the influential WHO Report on the Social Determinants of Health (SDoH) in 2008. A group of senior international public health scholars and decision-makers met in Italy in mid-2019 to review the legacy of the SDoH conceptual framework and its adequacy for the many challenges facing our field as we enter the 2020s. Four major categories of challenges were identified: emerging "exogenous" challenges to global health equity, challenges related to weak policy and practice implementation, more fundamental challenges related to SDoH theory and research, and broader issues around modern research in general. Each of these categories is discussed, and potential solutions offered. We conclude that although the SDoH framework is still a worthy core platform for public health research, policy, and practice, the time is ripe for significant evolution.

The Victorian experience of transitional registration for Chinese Medicine practitioners and its implications for national registration.

BACKGROUND: Statutory registration of Chinese Medicine (CM) practitioners was introduced in Victoria in 2000. The application assessment process for those who were granted registration during the transitional period (2002-04) was resource intensive, as little was known about their age, education, practice and language proficiency. This study offers insights that may be useful for the planning of national registration to commence in 2012. METHODS: Data were extracted from registration application forms submitted to the Chinese Medicine Registration Board of Victoria (CMRB) between 2002 and 2004, using pre-defined data collection forms. RESULTS: In 2006, 639 'grandparented' Victorian CM practitioners had been registered, with a median age of 44 years old (range 23-86). There was a higher proportion of younger female, English-speaking, acupuncturists v. a higher proportion of older male, non-English-speaking, Chinese herbalists. There were few CM practitioners in rural areas, particularly herbalists. More than one-third of practitioners had obtained qualifications overseas and almost half of these practitioners provided no evidence of past study in professional issues and medical ethics. CONCLUSIONS: Ageing, diversity in qualifications and training, English proficiency, and level of study in professional issues and medical ethics represent major challenges for the implementation of CM national registration in 2012.

Fabrication of a nano-cone array on a p-GaN surface for enhanced light extraction efficiency from GaN-based tunable wavelength LEDs.

We report on the fabrication of a nano-cone structured p-GaN surface for enhanced light extraction from tunable wavelength light emitting diodes (LEDs). Prior to p-contact metallization, self-assembled colloidal particles are deposited and used as a mask for plasma etching to create nano-cone structures on the p-GaN layer of LEDs. A well-defined periodic nano-cone array, with an average cone diameter of 300 nm and height of 150 nm, is generated on the p-GaN surface. The photoluminescence emission intensity recorded from the regions with the nano-cone array is increased by two times as compared to LEDs without surface patterning. The light output power from the LEDs with surface nano-cones shows significantly higher electroluminescence intensity at an injection current of 70 mA. This is due to the internal multiple scattering of light from the nano-cone sidewalls. Furthermore, we have shown that with an incorporation of InGaN nanostructures in the quantum well, the wavelength of these surface-patterned LEDs can be tuned from 517 to 488 nm with an increase in the injection current. This methodology may serve as a practical approach to increase the light extraction efficiency from wavelength tunable LEDs.