Health and Movement

FOCUS AREA ONE: HEALTH FOR INDIVIDUALS AND COMMUNITIES - 40 HOURS

1. How do we understand and measure Australia's health?

Compare meanings of health, including WHO definition

• 500 BC: equal mingling of elements of human nature

• 1913: state of being hale, sound, whole in body mind or soul, free from disease

• 1946 WHO: A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity

• 2022: presence or absence of disease or medically measured risk factors

• Why different meanings: health is subjective, influenced by culture, age, gender, education, lived experience, SES, Aboriginal holistic view - health = connection to Country, kin, spirit

• Modern view = holistic, dynamic, multidimensional

Explain the dynamic nature of health

• Dynamic = constantly changing

• 5 dimensions: physical, mental, emotional, social, spiritual - all interact. Eg. injury (physical) -> isolation (social) -> anxiety (mental)

• Concept of good health = not just absence of illness but positive wellbeing

• Health continuum: high-level wellness -> good health -> average -> ill health -> chronic illness -> premature death. Individuals move along it over time

• Circumstances affecting health: SES, geographic location, gender, genetics, education, employment, culture, age

Discuss epidemiology measures to explain health status

• Epidemiology: study of distribution and determinants of health-related states

• Mortality: number/rate of deaths in population in given time

• Infant mortality: deaths of children under 1 per 1000 live births - indicator of health system

• Morbidity: ill health in individual / levels of ill health in population

• Incidence: number of NEW cases during given period

• Prevalence: total number/proportion existing at given time

• Use data from Australia's Health AIHW reports - graphs and tables show leading causes of death, burden of disease

Investigate social justice principles

• Equity vs Equality: Equality = everyone gets same. Equity = resources to those who need most

• Access: to services, education, healthcare, shelter, food, transport

• Participation: shifting power, empowering communities to make decisions about their health

• Rights: right to health, to be treated with dignity, to cultural safety

• Example: Aboriginal Community Controlled Health Organisations - participation and culturally appropriate access

Determinants that influence health and wellbeing of Australians

Broad features of society:

• Culture, affluence, social cohesion, social inclusion, political structures, media, language

Environmental factors:

• Geographical location (rural/remote = ↑ hospitalisation, ↓ life expectancy, ↑ risky behaviours, ↓ access to primary health, ↓ Year 12 completion, ↑ chronic disease), safe workplaces, air/water quality, community safety, access to physical resources

Socioeconomic characteristics:

• Education attainment, employment status, SES, cultural background, disability, social networks/media, social expectations

Health behaviours:

• Tobacco/alcohol use, physical activity, dietary behaviour, illicit drug use, sexual practices, vaccination

Biomedical factors:

• Genetics, blood pressure, blood glucose, cholesterol, body weight, physical impairment

Key question: How do determinants interact? Example - Low income family -> can't afford healthy food -> processed diet + low activity -> ↑ CVD, diabetes, mental health. Social + economic + behavioural + biomedical interact.

Sociological causes of risky behaviours: peer pressure, social norms, media glamorisation, lack of connectedness, low health literacy, coping mechanism for stress

Where inequities exist: Aboriginal and Torres Strait Islander peoples, rural/remote, low SES, homeless, CALD, LGBTIQ+, people with disability

2. What are young people's meanings of health?

Similarities and differences across generations

• Similarities: social, emotional, physical changes, seeking independence, identity, sense of purpose, peer importance

• Differences: greater levels of education, increased tech access, delaying marriage/mortgages, climate anxiety, social media pressures, more open discussion of mental health

• Influences: family, peers, culture, technology, global events (COVID, climate)

Investigate meanings of health for young people - research method
You must know research process for yearly:

• Create research question: e.g. What does health mean to Year 11 students at NBCS?

• Develop methods: surveys, interviews, focus groups, photovoice

• Consider determinants impacting their meaning

• Analyse different ways young people define what is important

• Ethical considerations: consent (informed, voluntary), do no harm, confidentiality, anonymity, debrief

• Validity: does it measure what it intends? Truthfulness

• Reliability: consistency over time, representative of total population

• Credibility: trustworthy, accurate

• Present findings, draw conclusions, identify further research questions

3. What key issues affect the health of young people and how can they protect and promote good health?

Health status of young people using Australia's Health

• 46% of 18-24 overweight/obese 2017-18

• 26.3% of 18-24 exceeded alcohol guidelines 2020-21

• 21.7% of 18-24 had vaped at least once, 4.8% regularly

• 27.5% of 15-24 had mental health/behavioural problems

• Leading burden: anxiety, depression, suicide, road injuries

Aboriginal and Torres Strait Islander young people:

• Poorer access due to availability, cost, lack of culturally appropriate services

• Leading disease groups: mental and substance use disorders, injuries, CVD, cancer, musculoskeletal

• Burden of disease 2.3x rate of non-Indigenous

Research ONE health issue - you need a case study. Example: Mental health / vaping / sexual health / respectful relationships

Structure for any issue:

• Nature: what is it? Eg. Vaping = inhalation of aerosol from e-cigarettes with nicotine/flavourings

• Data: prevalence, incidence, trends from AIHW

• Why is it an issue? Causes - peer pressure, marketing, stress, lack of knowledge. Risk factors

• Protective factors: strong positive relationships with parents/teachers, good physical/mental health, close friends/family, community connection, hope for future, school engagement

• Strategies currently in place: individual (communication, boundary setting), community (PDHPE consent education), government campaigns (NSW Quit Vaping), NGOs, private businesses awareness

• New strategies most effective: peer-led education, restrictions on marketing, support services, health literacy programs

• Further research: longitudinal effects, effectiveness of interventions

Skills for strengthening the individual - link to your researched issue:

• Self-efficacy: belief in own ability to manage behaviour/emotions

• Health literacy: ability to access, analyse, act on health information

• Help-seeking behaviours: self-awareness to ask for support and know where to go (GP, Kids Helpline, Headspace, ACCHOs)

• Problem-solving: finding solutions to complex situations

• Resilience: bounce back, adapt positively

• Coping strategies: tools to manage stress (exercise, mindfulness, talking)

• Sense of purpose: meaningful goal to direct effort

• Ethical behaviour: fairness, integrity, honesty, empathy

• Connectedness: belonging socially, emotionally, spiritually, professionally

Reflect on own health: identify behaviours, set SMART goals for improvement

4. What are the opportunities for improving and promoting young people's health?

How young people advocate

• Advocacy = supporting needs/interests, standing up for rights, pushing change

• Ways: SRC, Youth Parliament, Young Australian of the Year, Youth Action, social media campaigns, petitions, peer education

• Role of individual within community - can't rely on others

Organisations and communities advocating:

• Youth Action: peak organisation for young people and youth services, policy papers, Western Sydney Project, Ask for Health (trusted health info), Youth Justice Throughcare, Fair Go for Young People campaign

• Government: NSW Health, Department of Education PDHPE syllabus

• NGOs: Headspace, ReachOut, Beyond Blue

• ACCHOs: Aboriginal Community Controlled Health Organisations - work with community, need extensive knowledge of local culture, provide holistic culturally safe care, improve access, self-determination

Nature of health promotion in Australia

• Definition: process of enabling people to increase control over and improve their health - beyond individual behaviour to social/environmental interventions

Models:

• Biomedical model: health = absence of disease, treats once symptoms present, focuses on physical/biological, relies on technology, does not consider determinants. Reactive

• Socio-cultural model: addresses broader influences, focuses on policies, education, health promotion, modifies factors beyond individual control, cost-effective, prevention focused

• Salutogenic model: What causes health? Proactive, realistic, about reaching potential, assumes inherently flawed

• Pathogenic model: What causes disease? About avoiding illness, reactive, idealistic, assumes inherently healthy

• Ecological model: no single factor explains risk, focuses on interaction of individual and social determinants

Global policies impacting Australia:

• WHO setting global priorities, COVID guidelines, health promotion frameworks

• UNESCO, UNICEF - Ending HIV campaigns, vaccinations for COVID/measles

• Ottawa Charter 1986: holistic view, environment impacts health as much as individual, prerequisites: peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice and equity

• 5 Action Areas: 1. Build healthy public policy (e.g. increased tobacco tax), 2. Strengthen community action (AA groups, community gardens), 3. Develop personal skills (mandatory PDHPE), 4. Create supportive environments (Quitline, smoke-free areas), 5. Reorient health services (prevention focus, speed bumps). Together they advocate, enable, mediate

UN Sustainable Development Goals SDGs

• 17 Global Goals by UN to achieve by 2030, interconnected, 3 pillars: economic, social, environmental

• List: 1 No Poverty, 2 Zero Hunger, 3 Good Health and Wellbeing, 4 Quality Education, 5 Gender Equality, 6 Clean Water and Sanitation, 7 Affordable Clean Energy, 8 Decent Work and Economic Growth, 9 Industry Innovation Infrastructure, 10 Reduced Inequalities, 11 Sustainable Cities Communities, 12 Responsible Consumption Production, 13 Climate Action, 14 Life Below Water, 15 Life on Land, 16 Peace Justice Strong Institutions, 17 Partnerships for Goals

• WHO health lens: applying goals to target health outcomes, universal health coverage for all, no one left behind

• Used in Australia: collaboration across sectors. Example: Solar my School - powers >90% Eastern Suburbs schools with clean energy, founded by local council 2017, SDGs 7,11,13

• For young people locally: SDG 4 Quality Education - Individual: tutor for free, Structural: 5000 meals program NGO teaches kids to cook. Can propose local actions for any SDG

FOCUS AREA TWO: THE BODY AND MIND IN MOTION - 40 HOURS

1. How do the systems of the body influence and respond to movement?

Skeletal and Muscular interrelationship

Bones: provide support, protection, movement, red blood cell production, mineral storage

• Types: Long (femur - weight bearing), Short (carpals - stability), Flat (ribs - protection), Irregular (vertebrae - protection), Sesamoid (patella)

• Functions: shape/support, muscle attachment, protection (skull brain, vertebrae spinal cord, ribs heart/lungs), blood production in marrow

Joints: where 2+ bones meet, classified by movement

• Fibrous: immovable, protection e.g. sutures skull, sternum

• Cartilaginous: slightly moveable, cartilage e.g. between vertebrae

• Synovial: freely moveable, cavity with synovial fluid lubricates. 90% of joints

Synovial types:

• Gliding: flat surfaces slide, e.g. tarsals ankle

• Hinge: convex into concave, uniaxial 1 plane flexion/extension e.g. knee, elbow

• Pivot: ring-shaped pivots, rotation e.g. radius/ulna, atlas/axis neck

• Saddle: saddle + rider, multi-directional e.g. carpal + metacarpal thumb

• Condyloid: oval into depression, 2 planes e.g. wrist

• Ball and socket: ball into cup, multiaxial flexion/extension, abduction/adduction, rotation e.g. shoulder, hip - most mobile

Joint actions: Flexion (angle decreases), Extension (increases), Abduction (away from midline), Adduction (towards), Rotation (turns on axis), Circumduction (circular), Pronation (palm down), Supination (palm up), Dorsiflexion (foot up), Plantar flexion (foot down), Elevation/depression shoulder

Ligaments: bone to bone, fibrous slightly elastic, stability, keep joint together

Muscles: generate force by contracting/relaxing

• Types: Skeletal (voluntary, striated, multinucleated, to bone), Smooth (involuntary, non-striated, organs, peristalsis, vasoconstriction), Cardiac (involuntary, striated with intercalated discs, heart only)

• Functions: movement, posture/stability, heat production (byproduct), blood circulation (helps venous return), respiration (diaphragm/intercostals)

Muscle fibres:

• Slow twitch Type I: endurance, aerobic system, high mitochondria, myoglobin, aerobic enzymes, ATP production, fatigue resistant e.g. marathon

• Fast twitch IIa: intermediate speed, larger diameter, speed-endurance e.g. 800m

• Fast twitch IIb: large cross-section, high force/power, explosive anaerobic e.g. 100m sprint

Types of contraction:

• Isotonic concentric: muscle shortens, tension developed, moves opposite gravity e.g. bicep curl up

• Isotonic eccentric: muscle lengthens under tension, same direction gravity, controls movement e.g. lowering weight

• Isometric: no change length, contracts no movement e.g. gripping racket, plank

• Isokinetic: changes length against varying load at constant speed, needs specialised equipment

Muscle relationships:

• Origin = attachment that doesn't move, proximal closer to midline

• Insertion = attachment that moves, distal further

• Agonist = prime mover responsible

• Antagonist = relaxes to allow movement

• Fixator/stabiliser = isometric stabilises origin for maximal force (proximal stabilisation)

• Synergist = assists, controls surrounding muscles for smooth movement

• Reciprocal inhibition: one side relaxes to allow other to contract. Eg. bicep curl: biceps agonist contracts, triceps antagonist relaxes

Biomechanical principles for safe movement

• Motion: linear, angular, general

• Balance and stability: centre of gravity, base of support, line of gravity. Wider base = more stable, lower COG = more stable

• Fluid mechanics: drag (air/water resistance), frontal area (streamlined position in swimming reduces drag), smoothness (shaving body hair), lift

• Force: Newton’s laws - 1st law inertia (object at rest stays at rest unless force), 2nd F=ma, 3rd action-reaction

• Application: bending knees to lower COG when tackling, increasing base in wrestling, using large muscle groups

Respiratory and Circulatory interrelationship

Respiratory structure:

• Air passages: nasal cavity/mouth -> pharynx -> larynx -> trachea -> bronchi -> bronchioles -> alveoli (gas exchange)

• Lungs in thoracic cavity protected by ribs/sternum/vertebrae, contain bronchi/bronchioles/alveoli

• Diaphragm: involuntary/smooth muscle, moves up/down changes chest cavity volume for breathing

Gas exchange:

• Diffusion high to low concentration through semipermeable membrane

• At alveoli/capillary: O2 high in alveoli -> low in capillaries (into blood), CO2 high in capillaries -> low in alveoli (expired)

• At capillary/muscle: O2 high in capillaries -> low in muscle, CO2 high in muscle -> low in capillaries

• Maintained by continuous breathing and blood flow

Mechanics of breathing: inspiration = diaphragm contracts down, intercostals expand chest, pressure decreases air in. Expiration = passive.

Circulatory system:

• Network arteries, veins, capillaries, heart pumping

• Functions: circulate blood, transport O2 water nutrients, transport CO2 waste, maintain temp (vasodilation/vasoconstriction), white cells fight infection

• At rest 20% cardiac output to muscles, maximal exercise 80-90% to muscles via vasodilation

Heart structure: protected by ribs, 2 sides 4 chambers: Left atrium receives oxygenated, Right atrium deoxygenated, Left ventricle pumps oxygenated to body, Right ventricle pumps deoxygenated to lungs

• Systemic circulation: left side -> aorta -> body -> vena cava -> right side

• Pulmonary: right side -> pulmonary artery (deoxygenated) -> lungs -> pulmonary vein (oxygenated) -> left side

• Veins toward heart deoxygenated (except pulmonary veins), Arteries away oxygenated (except pulmonary arteries), Capillaries diffusion site

Blood: Plasma 55%, RBC 45% (haemoglobin carries O2), WBC <1%, platelets clotting

Key formulas:

• Cardiac output Q = HR x SV. Q = blood ejected per minute, HR = beats per minute, SV = amount ejected per beat from left ventricle

Interrelationship during exercise:

• Demand for O2 increases -> cardiovascular responses increase: HR, SV, Q. Respiratory: respiratory rate RR, tidal volume, ventilation increase proportionally

• Controlled by respiratory control centre in brainstem monitoring O2/CO2, adjusts RR and HR for homeostasis

Factors impacting efficiency:

• Altitude: less air pressure, low pressure differential alveoli-capillaries, harder to breathe, lower VO2 max

• Haemoglobin levels: high = increased endurance, reduced fatigue, improved performance. Low = reduced O2 supply, fatigue

• Vascular disease: atherosclerosis narrows arteries, restricts blood flow, reduces O2 delivery

Digestive and Endocrine interrelationship

Digestive function: extracts nutrients, absorbs into blood for energy, repair, reproduction, growth, maintenance

Structure:

• Digestive tract: mouth -> oesophagus -> stomach -> small intestine -> large intestine -> anus

• Accessory: salivary glands, pancreas, liver, gallbladder

Mouth: mastication chewing, saliva contains amylase begins starch breakdown, bolus formed by tongue pushed to pharynx

• Oesophagus: peristalsis smooth muscle involuntary contraction

• Stomach: smooth muscle churns with gastric juices -> chyme soupy liquid -> small intestine

• Small intestine: main absorption of nutrients through walls into bloodstream

• Large intestine: remaining water/nutrients absorbed, leftover becomes stool

• Accessory: salivary amylase, pancreas pancreatic juices breakdown carbs/fats/proteins, liver bile emulsifies fats neutralises acid, gallbladder stores bile, bile duct -> small intestine emulsification

Endocrine system: glands secrete hormones directly into bloodstream, chemical messages to target cells

• Pituitary: growth hormone stimulates muscle/bone growth

• Thyroid: T4 thyroxine, T3 triiodothyronine increase metabolic rate, energy utilisation, muscle function

• Adrenal: adrenaline increases HR, strength, energy production. Cortisol regulates metabolism, reduces inflammation, energy production

• Pancreas: glucagon breaks down glycogen to glucose for energy during prolonged exercise, insulin promotes glucose uptake/storage for muscle contraction

• Testes: testosterone maintains muscle mass/strength, recovery

• Ovaries: estrogen maintains muscle mass/strength, recovery

• Parathyroid: PTH regulates calcium for contraction

• Pineal: melatonin regulates sleep-wake circadian rhythms

• Others: serotonin/dopamine mood/cognitive, leptin/ghrelin hunger/satiety

Functions: homeostasis (stable equilibrium), metabolism regulation, growth/development, stress response (cortisol/adrenaline), energy balance/appetite, mood, circadian rhythms, reproduction

Interrelationship:

• Work together to regulate appetite, digestion, metabolism, energy balance, blood glucose

• Both break down food into nutrients absorbed for working muscles for energy, growth/repair

• Endocrine controls digestive processes: insulin/glucagon regulate blood glucose, gastrin controls gastric juices. During exercise pancreas releases glucagon suppresses insulin to mobilise glucose

Factors impacting efficiency: macronutrients, micronutrients, stress, hydration, sleep

Nervous system and movement

Function: sensory input -> processing -> motor output

• Sensory receptors detect stimuli send to brain/spinal cord

• Brain interprets decides response

• Motor neurons send signals to muscles contract/relax

Functions:

1. Sensory input and processing: visual, auditory, proprioceptive (position), processes to inform movement

2. Motor control and coordination: sends commands, coordinates complex movements

3. Learning and adaptation: forms neural pathways through practice, muscle memory

Structure:

• CNS = brain and spinal cord. Brain: Motor cortex initiates voluntary movement, Cerebellum balance/coordination, Basal ganglia modulates movements, Brainstem autonomic functions maintains stamina/endurance

• PNS = carries motor commands from CNS to muscles/glands enabling movement. Sensory neurons to CNS, motor neurons from CNS

Example batting in cricket: eyes sensory neurons detect ball -> optic nerve -> brain analyses speed/line/length -> selects shot -> action potential to spinal cord -> motor neuron dendrites -> cell body -> axon -> motor end plate at muscle -> motor unit (motor neuron + all fibres it innervates) if stimulus reaches threshold contracts at 100% when calcium released. Sensory feedback about how movement felt, eyes track where ball hit.

Systems working together - kicking football:

• Circulatory: transports O2/nutrients removes waste, heart pumps efficiently

• Respiratory: supplies O2 removes CO2, increased breathing rate

• Digestive: pre-game carbs provide energy

• Skeletal: femur/tibia/fibula support, stability

• Endocrine: adrenaline increases energy/alertness

• Muscular: quads/hamstrings contract extend/flex for powerful kick, force generation

• Nervous: controls voluntary movements, coordination, timing, precise force/direction

First aid role in response to movement

• Immediate care, assessment, stabilisation, first aid techniques

• Helps: inefficient movement, dehydration, undue stress, nerve pain, tennis/golf elbow, sprains, strains, concussion

• RICER for soft tissue, DRABCD for emergency

2. Energy Systems

ATP = adenosine triphosphate, energy currency. PCr = phosphocreatine stored in muscle, quickly regenerates ATP

Interplay: all 3 work at once but dominant shifts. 100m sprint = ATP-PCr dominant but aerobic still contributes. Marathon = aerobic dominant but ATP-PCr used at start/sprint finish.

3. Nutrition role in enabling energy systems

• Carbs broken to glucose stored as glycogen in muscles/liver, excess as fat in adipose

• Aerobic training main fuel carbs, but at low intensity more fat used. High intensity anaerobic needs more carbs, less fat, more protein for repair

• Fats provide more energy per gram (9kcal vs 4kcal carbs) but slower to digest, slower ATP production, preferred at low intensity

• Protein for muscle repair not main energy unless starvation

• Micronutrients vitamins/minerals: iron for haemoglobin, calcium for contraction, B vitamins for energy metabolism

• Hydration crucial for blood volume, temp regulation

4. Training types

Aerobic = with oxygen

• Continuous training: sustained submaximal e.g. 30 min run

• Fartlek: varied speed

• Long interval

Anaerobic = without oxygen

• Short high intensity, e.g. sprint intervals, plyometrics, resistance

FITT principle for program design: Frequency, Intensity, Time, Type. Plus progression, overload, specificity, reversibility, variety, warm-up/cool-down

Differentiated training: individuals vs team sports, different positions need different fitness (e.g. prop vs winger in rugby)

Contemporary methods: HIIT, Tabata, circuit, CrossFit, altitude training

5. Immediate physiological responses to training

• Heart rate ↑, Stroke volume ↑, Cardiac output ↑ (Q=HRxSV)

• Ventilation rate ↑ (breaths per min), Tidal volume ↑ (air per breath)

• Lactate levels ↑ during anaerobic, systolic blood pressure ↑

• Muscle temperature ↑, sweat rate ↑

6. Physiological responses to aerobic training (adaptations over time)

• Resting HR ↓, SV ↑, cardiac hypertrophy, capillarisation ↑, mitochondrial density ↑, myoglobin ↑, VO2 max ↑, lactate threshold ↑, lower blood pressure, improved fat utilisation

7. Fitness testing

Purpose: identify strengths/weaknesses, set goals, evaluate program, talent identification, motivation, compare to norms
Debate outcomes: for different groups - elite vs recreational vs children vs elderly. Should testing be norm-referenced? Ethical issues - body composition testing can cause body image issues, cultural sensitivity, validity for sport-specific, over-testing.

Tests: Beep test (VO2 max), sit and reach (flexibility), vertical jump (power), 40m sprint (speed), Illinois agility, 1RM strength

8. Movement skill acquisition

Types of practice:

• Distributed: shorter more frequent sessions, more rest between tasks - better for retention, less fatigue

• Massed: longer less frequent, shorter rest - for discrete skills, but fatigue

• Whole: skill practiced as whole e.g. layup - for simple/highly organised skills

• Part: broken into sections e.g. tennis serve toss then hit - for complex/low organisation

• Blocked: same skill continuously without change - for beginners

• Serial: different skills in predictable sequence

• Random: varied sequencing different skills same session - better for retention, for advanced

Stages of learning:

• Cognitive: beginner grasps what is required, many errors, needs instruction, conscious thought

• Associative: knows what required, kinaesthetic sense improves, fewer errors, can detect own errors

• Autonomous: executes automatically, low conscious effort, can focus on tactics

Characteristics of motor skills:

• Open: unpredictable changing environment e.g. tackling in rugby, defending in soccer - requires adaptability

• Closed: stable predictable environment e.g. vault gymnastics, free throw basketball - self-paced

• Gross: large muscle groups e.g. swimming, running

• Fine: small muscle groups e.g. catching, darts, typing

9. Psychology, movement and performance

Motivation:

• Extrinsic: external - money, trophies, winning, praise, scholarships. Can lead to pressure, overtraining, dropout if not internalised

• Intrinsic: internal - enjoyment, self-challenge, mastery, satisfaction. More sustainable, better for long-term participation

• Positive and negative forms of both

Communities of exercise motivating:

• Social support, belonging, accountability, shared goals, role models, group cohesion, exercise groups (parkrun, CrossFit box, team), online Strava communities, cultural exercise groups

• Investigate how they improve adherence, enjoyment, performanc