The wellness guide for carers

"Advice for carers on how to look after their own physical and mental health while they are caring for someone with a disability."

Examination of the "all hazards" approach to disaster management as applied to field disaster management and pre-hospital care in Australia

Disasters, emergencies, incidents, and major incidents - they all come back to the same thing regardless of what they are called. The common denominator is that there is loss of life, injury to people and animals and damage and destruction of property. The management of such events relies on four phases: 1. Prevention 2. Preparation 3. Response 4. Recovery Each of these phases is managed in a different way and often by different teams. Here, concentration has been given to phases 2 and 3, with particular emphasis on phase 3, Response. The words used to describe such events are often related to legislation. The terminology is detailed later. However, whatever the description, whenever prevention is not possible, or fails, then the need is to respond. Response is always better when the responders are prepared. Training is a major part of response preparation and this book is designed to assist those in the health industry who need to be ready when something happens. One of the training packages for responders is the Major Incident Medical Management and Support (MIMMS) Course and this work was designed to supplement the manual prepared by Hodgetts and Macway-Jones(87) in the UK. Included is what the health services responder, who may be sent to an event in which the main concern is trauma, should know. Concentration is on the initial response and does not deal in any detail with hospital reaction, the public health aspects, or the mental health support that provides psychological help to victims and responders, and which are also essential parts of disaster management. People, in times of disaster, have always been quick to offer assistance. It is now well recognised however, that the 'enthusiastic amateur', whilst being a well meaning volunteer, isn't always what is needed. All too often such people have made things worse and have sometimes ended up as victims themselves. There is a place now for volunteers and there probably always will be. The big difference is that these people must be well informed, well trained and well practiced if they are to be effective. Fortunately such people and organisations do exist. Without the work of the St John Ambulance, the State Emergency Service, the Rural Fire Service the Red Cross and the Volunteer Rescue Association, to mention only a few, our response to disasters would be far less effective. There is a strong history of individuals being available to help the community in times of crisis. Mostly these people were volunteers but there has also always been the need for a core of professional support. In the recent past, professional support mechanisms have been developed from lessons learned, particularly to situations that need a rapid and well organised response. As lessons are learned from an analysis of events, philosophy and methods have changed. Our present system is not perfect and perhaps never will be. The need for an 'all-hazards approach' makes detailed planning very difficult and so there will probably always be criticisms about the way an event was handled. Hindsight is a wonderful thing, provided we learn from it. That means that this text is certainly not the 'last word' and revisions as we learn from experience will be inevitable. Because the author works primarily in New South Wales, many of the explanations and examples are specific to that state. In Australia disaster response is a State, rather than a Commonwealth, responsibility and consequently, and inevitably, there are differences in management between the states and territories within Australia. With the influence of Emergency Management Australia, these differences are being reduced. This means that across state and territory boundaries, assistance is common and interstate teams can be deployed and assimilated into the response rapidly, safely, effectively and with minimum explanation. This text sets out to increase the understanding of what is required, what is in place and how the processes of response are managed. By way of introduction and background, examples are given of those situations that have occurred, or could happen. Man Made Disasters has been divided into two distinct sections. Those which are related to structures or transport and those related directly to people. The first section, Chapter 3, includes: • Transport accidents involving land, rail, sea or air vehicles. • Collapse of buildings for reasons other than earthquakes or storms. • Industrial accidents, including the release of hazardous substances and nuclear events. A second section dealing with the consequences of the direct actions of people is separated as Chapter 4, entitled 'People Disasters'. Included are: • Crowd incidents involving sports and entertainment venues. • Terrorism From Chapter 4 on, the emphasis is on the Response phase and deals with organisation and response techniques in detail. Finally there is a section on terminology and abbreviations. An appendix details a typical disaster pack content. War, the greatest of all man made disasters is not considered in this text.

Exposure estimation, uncertainty and variability in occupational hygiene retrospective assessment

This thesis reports on a quantitative exposure assessment and on an analysis of the attributes of the data used in the estimations, in particular distinguishing between its uncertainty and variability. A retrospective assessment of exposure to benzene was carried out for a case control study of leukaemia in the Australian petroleum industry. The study used the mean of personal task-based measurements (Base Estimates) in a deterministic algorithm and applied factors to model back to places, times etc for which no exposure measurements were available. Mean daily exposures were estimated, on an individual subject basis, by summing the task-based exposures. These mean exposures were multiplied by the years spent on each job to provide exposure estimates in ppm-years. These were summed to provide a Cumulative Estimate for each subject. Validation was completed for the model and key inputs. Exposures were low, most jobs were below TWA of 5 ppm benzene. Exposures in terminals were generally higher than at refineries. Cumulative Estimates ranged from 0.005 to 50.9 ppm-years, with 84 percent less than 10 ppm-years. Exposure probability distributions were developed for tanker drivers using Monte Carlo simulation of the exposure estimation algorithm. The outcome was a lognormal distribution of exposure for each driver. These provide the basis for alternative risk assessment metrics e.g. the frequency of short but intense exposures which provided only a minimal contribution to the long-term average exposure but may increase risk of leukaemia. The effect of different inputs to the model were examined and their significance assessed using Monte Carlo simulation. The Base Estimates were the most important determinant of exposure in the model. The sources of variability in the measured data were examined, including the effect of having censored data and the between and within-worker variability. The sources of uncertainty in the exposure estimates were analysed and consequential improvements in exposure assessment identified. Monte Carlo sampling was also used to examine the uncertainties and variability associated with the tanker drivers' exposure assessment, to derive an estimate of the range and to put confidence intervals on the daily mean exposures. The identified uncertainty was less than the variability associated with the estimates. The traditional approach to exposure estimation typically derives only point estimates of mean exposure. The approach developed here allows a range of exposure estimates to be made and provides a more flexible and improved basis for risk assessment.

Hexavalent chromium in welding fume

Evaluates the current Australian Standard method (AS3853.1) for the determination of total hexavalent chromium (Cr(VI)) in stainless steel welding fume. Investigates the extraction kinetics of this Cr(VI) into a range of media. Develops an analytical method for the determination of Cr(VI) in acidic extract solutions and investigates the extraction of Cr(VI) under simulated in vivo conditions.

Changes in antecedents of BMI between 1976 and 2006

Overweight/obesity has reached epidemic proportions in Australia. This thesis confirmed and extended the relationship between lifestyle and body mass index in that dense energy foods, snacking and low levels of physical activity were associated with higher BMI while plant foods, vegetarianism and, in men, large breakfasts were associated with lower BMI.

Psychosocial epidemiology of colorectal cancer

The research explored the role played by personality and stress in the development and progress of colorectal cancer. Personality type was related to health outcomes following diagnosis, and to participation in bowel cancer screening. The personality types also differed in terms of their capacity to deal with stress.

Physical activity advice and obesity

Current physical activity guidelines need to be modified to incorporate specific recommendations for obese people and consideration needs to be given to greater collaboration among health care providers to provide a multi disciplinary team approach that may be a more effective method of managing obesity and promoting physical activity.

Caring for carers

The Carer Analytic Tool was developed to identify the psychological, social and physical support needs of unpaid carers. The Tool was shown to be valid and reliable. It proactively identifies the unmet support needs of carers in the areas of aged care, disability and mental health.

Spirituality and coping in young adults with diabetes

This exploratory study with a combination of quantitative and qualitative methods addressed an important aspect of life that could help young adults with diabetes cope with stressful situations and manage their diabetes. The study aimed to explore young adults with diabetes' spirituality and how spirituality that focuses on inner-self and transformation can enhance their coping and diabetes management. The findings can also help health professionals integrate spirituality into diabetes care.

Subjective quality of life of people with MS and their partners

The findings of this thesis supported a model proposed to explain the influence of psychological factors on subjective quality of life. In comparison with their partners, and with a control group, people with MS reported a lowered subjective quality of life and self-esteem, an increased need for social support, and maladaptive use of control. Recommendations for interventions were made based on these findings.

Guiding policy change to reduce diet-related disease in the Pacific

Research was undertaken in Fiji and Tonga to identify the most promising policy interventions to improve diets and non-communicable diseases. The participatory approach combined with modelling enabled evidence-informed decision-making by stakeholders. The framework developed is practical and systematic and is recommended for use in other countries in the region.

Religiosity and subjective wellbeing in Christianity, Buddhism and Taoism

The relationship between three religions (Christianity, Buddhism and Taoism) and subjective wellbeing were studied. Religiosity and spirituality-religion satisfaction were significant predictors of subjective wellbeing. A new construct of religious self-esteem and a new scale of Christianity secondary control were found as useful in explaining subjective wellbeing.