A cross-sectional analysis of patterns of obesity in a cohort of working nurses and midwives in Australia, New Zealand, and the United Kingdom

Objective The aim of this study was to examine the prevalence of overweight and obesity and the association with demographic, reproductive work variables in a representative cohort of working nurses and midwives. Design A cross sectional study of self reported survey data. Settings Australia, New Zealand and the United Kingdom. Methods Measurement outcomes included BMI categories, demographic (age, gender, marital status, ethnicity), reproductive (parity, number of births, mother's age at first birth, birth type and menopausal status) and workforce (registration council, employment type and principal specialty) variables. Participants 4996 respondents to the Nurses and Midwives e-Cohort study who were currently registered and working in nursing or midwifery in Australia (n=3144), New Zealand (n=778) or the United Kingdom (n=1074). Results Amongst the sample 61.87% were outside the healthy weight range and across all three jurisdictions the prevalence of obesity in nurses and midwives exceeded rates in the source populations by 1.73% up to 3.74%. Being overweight or obese was significantly associated with increasing age (35–44 yrs aOR 1.71, 95% CI 1.41–2.08; 45–55 yrs aOR 1.90, 95%CI 1.56–2.31; 55–64 aOR 2.22, 95% CI 1.71–2.88), and male gender (aOR 1.46, 95% CI 1.15–1.87). Primiparous nurses and midwives were more likely to be overweight or obese (aOR 1.37, 95% CI 1.06–1.76) as were those who had reached menopause (aOR 1.37, 95% CI 1.11–1.69). Nurses and midwives in part-time or casual employment had significantly reduced risk of being overweight or obese, (aOR 0.81, 95% CI 0.70–0.94 and aOR 0.75, 95% CI 0.59–0.96 respectively), whilst working in aged carried increased risk (aOR 1.37, 95% CI 1.04–1.80). Conclusion Nurses and midwives in this study have higher prevalence of obesity and overweight than the general population and those who are older, male, or female primiparous and menopausal have significantly higher risk of overweight or obesity as do those working fulltime, or in aged care. The consequences of overweight and obesity in this occupational group may impact on their workforce participation, their management of overweight and obese patients in their care as well as influencing their individual health behaviours and risks of occupational injury and chronic disease.

Contemporaneous correlations within individuals in an automated web-based walking program (Walk@Work) over a six week period (three phases) of time

Introduction: Participants may respond to phases of a workplace walking program at different rates. This study evaluated the factors that contribute to the number of steps through phases of the program. The intervention was automated through a web-based program designed to increase workday walking. Methods: The study reviewed independent variable influences throughout phases I–III. A convenience sample of university workers (n=56; 43.6±1.7 years; BMI 27.44±.2.15 kg/m2; 48 female) were recruited at worksites in Australia. These workers were given a pedometer (Yamax SW 200) and access to the website program. For analyses, step counts entered by workers into the website were downloaded and mean workday steps were compared using a seemingly unrelated regression. This model was employed to capture the contemporaneous correlation within individuals in the study across observed time periods. Results: The model predicts that the 36 subjects with complete information took an average 7460 steps in the baseline two week period. After phase I, statistically significance increases in steps (from baseline) were explained by age, working status (full or part time), occupation (academic or professional), and self reported public transport (PT) use (marginally significant). Full time workers walked more than part time workers by about 440 steps, professionals walked about 300 steps more than academics, and PT users walked about 400 steps more than non-PT users. The ability to differentiate steps after two weeks among participants suggests a differential affect of the program after only two weeks. On average participants increased steps from week two to four by about 525 steps, but regular auto users had nearly 750 steps less than non-auto users at week four. The effect of age was diminished in the 4th week of observation and accounted for 34 steps per year of age. In phase III, discriminating between participants became more difficult, with only age effects differentiating their increase over baseline. The marginal effect of age by phase III compared to phase I, increased from 36 to 50, suggesting a 14 step per year increase from the 2nd to 6th week. Discussion: The findings suggest that participants responded to the program at different rates, with uniformity of effect achieved by the 6th week. Participants increased steps, however a tapering off occurred over time. Age played the most consistent role in predicting steps over the program. PT use was associated with increased step counts, while Auto use was associated with decreased step counts.

Communication and the casualisation of nursing : a critical ethnography

The contemporary working environment is being rapidly reshaped by technological, industrial and political forces. Increased global competitiveness and an emphasis on productivity have led to the appearance of alternative methods of employment, such as part-time, casual and itinerant work, allowing greater flexibility. This allows for the development of a core permanent staff and the simultaneous utilisation of casual staff according to business needs. Flexible workers across industries are generally referred to as the non-standard workforce and full-time permanent workers as the standard workforce. Even though labour flexibility favours the employer, increased opportunity for flexible work has been embraced by women for many reasons, including the gender struggle for greater economic independence and social equality. Consequently, the largely female nursing industry, both nationally and internationally, has been caught up in this wave of change. This ageing workforce has been at the forefront of the push for flexibility with recent figures showing almost half the nursing workforce is employed in non-standard capacity. In part, this has allowed women to fulfil caring roles outside their work, to ease off nearing retirement and to supplement the family income. More significantly, however, flexibility has developed as an economic management initiative, as a strategy for cost constraint. The result has been the development of a dual workforce and as suggested by Pocock, Buchanan and Campbell (2004), associated deep-seated resentment and the marginalisation of part-time and casual workers by their full-time colleagues and managers. Additionally, as nursing currently faces serious recruitment and retention problems there is urgent need to understand the factors which are underlying present discontent in the nursing profession. There is an identified gap in nursing knowledge surrounding the issues relating to recruitment and retention. Communication involves speaking, listening, reading and writing and is an interactive process which is central to the lives of humans. Workplace communication refers to human interaction, information technology, and multimedia and print. It is the means to relationship building between workers, management, and their external environment and is critical to organisational effectiveness. Communication and language are integral to nursing performance (Hall, 2005), in twenty-four hour service however increasing fragmentation due to part-time and casual work in the nursing industry means that effective communication management has become increasingly difficult. More broadly it is known that disruption to communication systems impacts negatively on consumer outcomes. Because of this gap in understanding how nurses view their contemporary nursing world, an interpretative ethnographic study which progressed to a critical ethnographic study, based on the conceptual framework of constructionism and interpretativism was used. The study site was a division within an acute health care facility, and the relationship between increasing casualisation of the nursing workforce and the experiences of communication of standard and non-standard nurses was explored. For this study, full-time standard nurses were those employed to work in a specific unit for forty hours per week. Non-standard nurses were those employed part-time in specific units or those nurses employed to work as relief pool nurses for shift short falls where needed. Nurses employed by external agencies, but required to fill in for shifts at the facility were excluded from this research. This study involved an analysis of observational, interview and focus group data of standard and non-standard nurses within this facility. Three analytical findings - the organisation of nursing work; constructing the casual nurse as other; and the function of space, situate communication within a broader discussion about non-standard work and organisational culture. The study results suggest that a significant culture of marginalisation exists for nurses who work in a non-standard capacity and that this affects communication for nurses and has implications for the quality of patient care. The discussion draws on the seven elements of marginalisation described by Hall, Stephen and Melius (1994). The arguments propose that these elements underpin a culture which supports remnants of the historically gendered stereotype "the good nurse" and these cultural values contribute to practices and behaviour which marginalise all nurses, particularly those who work less than full-time. Gender inequality is argued to be at the heart of marginalising practices because of long standing subordination of nurses by the powerful medical profession, paralleling historical subordination of women in society. This has denied nurses adequate representation and voice in decision making. The new knowledge emanating from this study extends current knowledge of factors surrounding recruitment and retention and as such contributes to an understanding of the current and complex nursing environment.

Penal Colonies

Prostitution has been closely associated with the transportation of women convicts to British penal colonies. Convict labor was used to found a number of British colonies including Barbados, Jamaica, Maryland, Virginia, Singapore, New South Wales, Tasmania, and Western Australia. Between 1607 and 1939, Britain transported approximately 400,000 convicts, 162,000 of whom came to Australia and about 50,000 to North America. Significant numbers of women were among those transported to the Australian and North American colonies, although their numbers were relatively small in comparison to male convicts. Transportation was typically reserved for the most recalcitrant of female offenders. Most women transported came from working-class populations, resided in metropolitan centers, and were single at the time of their offense. Although few of these women were actually sentenced for activities associated with prostitution, large numbers had a history of involvement with prostitution. Transportation was considered to offer prostitutes a chance at redemption, with colonial commentators drawing contrasts between the Old World and its vice-ridden sensuality and the colonies, which offered opportunities for redemption through religious devotion and hard work. Many women transported to the Australian colonies were described by officials as being "on the town" at their time of apprehension and were collectively considered to be "damned whores, possessed of neither virtue nor honesty". Recently, historians have argued that these assessments were emblematic of middle-class prejudices toward the open and aggressive sexuality of working-class women. The number of convict women involved in prostitution may have been higher than recorded crimes, typically involving "larceny", suggest. A number of women were charged with theft from men who had paid them (or, in some instances, refused to pay them) for sex. Historians have estimated that one in five convict women were part-time or full-time prostitutes before transportation. Many continued in prostitution after transportation, with prostitution becoming an important element in the social and economic life of the Australian colonies, where, between 1788-1830, men outnumbered women six to one. Officially, prostitution was tolerated to dissuade men from vice. For women, prostitution presented a means of securing physical protection and accommodation at a time when general amenities and employment opportunities were restricted.

Socio-economic determinants for industry development : the case of Australia’s Sydney rock oyster industry

Socio-economic characteristics such as age, gender, educational attainment, employment status, and income contain vital information about how an industry may respond to changing circumstances, and hence are of importance to decision makers. While some socio-economic studies exist, relatively little attention has been given to fishery and aquaculture industries in regards to their socio-economic profiles and their role in the development prospects of these industries. In this study, by way of example, we focus on Australia’s Sydney rock oyster (Saccostrea glomerata) (SRO) industry. The aim of this study was identify the socio-economic profile of the SRO industry and to illustrate the value of such information for an industry management assessment. The SRO industry has experienced a major decrease in production volume since the late 1970 and continues to be affected by prevailing diseases and increasing market competition from Australia’s Pacific oyster (Crassostrea gigas) industry. It is likely that socio-economic aspects have influenced this development within the SRO industry. The socio-economic profile was developed using data from a SRO industry farm survey which was undertaken in 2012. Findings suggested that this industry is characterised by a mature aged oyster farmer population and a part-time oyster farming approach. These characteristics may affect the farmers’ ability to drive innovation and growth. The results also suggested that there may be potential industry entry barriers present in the SRO industry which may prevent younger people taking up oyster farming. Given the results, the study concluded that the current socio-economic profile of the industry has likely contributed to the present economic status quo of the industry.

Controlling routine front line service workers: an Australian retail supermarket case

Food retail is known for its use of flexible labour and for the centralisation of functions at head office, resulting in a reduction of managerial autonomy at store level. This article employs a typology of controls developed from labour process scholarship to explore how retail managers negotiate the control of their predominantly part-time workforce. Using an Australian supermarket chain as a case, and mixed methods, the article demonstrates that supermarkets use a multiplicity of forms of control across their workforce. For front line service workers, the article identifies a new configuration of controls which intersects with employment status and acts differentially for checkout operators on different employment contracts.

Patterns of entrepreneurial career development: An optimal matching analysis approach

Longitudinal studies of entrepreneurial career development are rare, and current knowledge of self-employment patterns and their relationships with individual difference characteristics is limited. In this study, the authors analyzed employment data from a subsample of 514 participants from the German Socio-Economic Panel study (1984–2008). Results of an optimal matching analysis indicated that a continuous self-employment pattern could be distinguished from four alternative employment patterns (change from employment to self-employment, full-time employees, part-time employees, and farmers). Results of a multinomial logistic regression analysis showed that certain socio-demographic characteristics (i.e., age and gender) and personality characteristics (i.e., conscientiousness and risk-taking propensity) were related to the likelihood of following a continuous self-employment pattern compared to the other employment patterns. Implications for future research on entrepreneurial career development are discussed.

Variation in the walking time to bus stop by the degree of transit captivity

Measures of transit accessibility are important in evaluating transit services, planning for future services and investment on land use development. Existing tools measure transit accessibility using averaged walking distance or walking time to public transit. Although the mode captivity may have significant implications on one’s willingness to walk to use public transit, this has not been addressed in the literature to date. Failed to distinguish transit captive users may lead to overestimated ridership and spatial coverage of transit services. The aim of this research is to integrate the concept of transit captivity into the analysis of walking access to public transit. The conventional way of defining “captive” and “choice” transit users showed no significant difference in their walking times according to a preliminary analysis. A cluster analysis technique is used to further divide “choice” users by three main factors, namely age group, labour force status and personal income. After eliminating “true captive” users, defined as those without driver’s licence or without a car in respective household, “non-true captive” users were classified into a total of eight groups having similar socio-economic characteristics. The analysis revealed significant differences in the walking times and patterns by their level of captivity to public transit. This paper challenges the rule-of-thumb of 400m walking distance to bus stops. In average, people’s willingness to walk dropped drastically at 268m and continued to drop constantly until it reached the mark of 670m, where there was another drastic drop of 17%, which left with only 10% of the total bus riders willing to walk 670m or more. This research found that mothers working part time were the ones with lowest transit captivity and thus most sensitive to the walking time, followed by high-income earners and the elderly. The level of captivity increases when public transit users earned lesser income, such as students and students working part time.

Understanding urban rail travel for improved patronage forecasting

Improved forecasting of urban rail patronage is essential for effective policy development and efficient planning for new rail infrastructure. Past modelling and forecasting of urban rail patronage has been based on legacy modelling approaches and often conducted at the general level of public transport demand, rather than being specific to urban rail. This project canvassed current Australian practice and international best practice to develop and estimate time series and cross-sectional models of rail patronage for Australian mainland state capital cities. This involved the implementation of a large online survey of rail riders and non-riders for each of the state capital cities, thereby resulting in a comprehensive database of respondent socio-economic profiles, travel experience, attitudes to rail and other modes of travel, together with stated preference responses to a wide range of urban travel scenarios. Estimation of the models provided a demonstration of their ability to provide information on the major influences on the urban rail travel decision. Rail fares, congestion and rail service supply all have a strong influence on rail patronage, while a number of less significant factors such as fuel price and access to a motor vehicle are also influential. Of note, too, is the relative homogeneity of rail user profiles across the state capitals. Rail users tended to have higher incomes and education levels. They are also younger and more likely to be in full-time employment than non-rail users. The project analysis reported here represents only a small proportion of what could be accomplished utilising the survey database. More comprehensive investigation was beyond the scope of the project and has been left for future work.

Re-invent yourself: from London intensive care nursing and the Nigerian oil fields to an an academic library in Brisbane; a career change worth making.

A complete change of career forces a seismic shift in every aspect of your life. From day one, you have to face the loss of long held beliefs, behaviours, the known world of self, and security. We came from professions that themselves are poles apart, and many of the challenges we faced entering the profession were the same: juggling full-time work, part time study, and family commitmemts, taking a pay cut, and loss of social life. But over a short period of time we both transitioned to our new profession successfully. so what make our successful transition possible?

Patterns of fitting cosmetically tinted contact lenses

Cosmetically tinted soft contact lenses are an attractive option for contact lens wearers. Data that we have gathered from annual contact lens fitting surveys demonstrate that those wearing tinted lenses are more likely to be female (4.6% of all soft lenses fitted vs. 1.6% for males; p < 0.0001) and younger (27 11 years vs. 33 13 years for those wearing non-tinted lenses; p < 0.0001). Tinted lenses tend to be worn more on a part-time basis and are replaced less frequently than non-tinted lenses. The decline in fitting tinted lenses over the past 12 years may be due to (a) the current limited availability of tinted lenses in silicone hydrogel materials and daily disposable replacement frequencies, which together represent a significant majority (78%) of new soft lenses fits today, (b) growing concerns among lens wearers and practitioners relating to the risks of complications associated with the wearing of tinted lenses, and (c) reduced promotion of such lenses by the contact lens industry.

The Revised Transactional Model (RTM) of occupational stress and coping : an improved process approach

Despite more than three decades of research, there is a limited understanding of the transactional processes of appraisal, stress and coping. This has led to calls for more focused research on the entire process that underlies these variables. To date, there remains a paucity of such research. The present study examined Lazarus and Folkman’s (1984) transactional model of stress and coping. One hundred and twenty nine Australian participants with full time employment (i.e. nurses and administration employees) were recruited. There were 49 male (age mean = 34, SD = 10.51) and 80 female (age mean = 36, SD = 10.31) participants. The analysis of three path models indicated that in addition to the original paths, which were found in Lazarus and Folkman’s transactional model (primary appraisal-->secondary appraisal-->stress-->coping), there were also direct links between primary appraisal and stress level time one and between stress level time one to stress level time two. This study has provided additional insights into the transactional process which will extend our understanding of how individuals appraise, cope and experience occupational stress.

Food insecurity in Brisbane : the single mother’s struggle

Using a feminist reflexive approach this paper reports on interviews with single mother’s in the Brisbane area about their experiences with food shopping and household food security. Preliminary findings suggest that most experience significant stress around the amount of money they have available for food. As the price of food and other costs of living increase, the only budget item that is flexible – groceries - is squeezed tighter. All women expressed a reluctance to ask for help from strangers at agencies instead relying on the support of family and friends to keep them food secure. Sometimes family and friends had no spare resources to help or were not aware of the extent their friend or relative might be struggling. The increased risks of poverty and food insecurity mean many go without as feeding the children takes precedence. The quality of their diets is variable with many reporting on aiming for quantity rather than being concerned with nutritional balance. Exhaustion and stress from being over-committed doing three roles, mother, father and housekeeper was self-identified as a key factor leading to mental health conditions such as depression, burnout and break down. Female single parent households are vulnerable to reducing welfare benefits as children grow or child support changes. Current policy forces single parents out to work but many can only manage part-time work for lower wages and are barely able to cope with this extra burden often resenting the reduction in benefits it brings. Public perceptions, derision and the notions of choice surrounding single parenting leave the cohort divided and silent for fear of reprisals. In my investigation issues arise about welfare policy that keep benefits low and workplace patriarchal power that can contribute to systemic poverty and the widening of the gender gap in poverty. So far analysis suggests a better support system around community food security including some hands on home help services, nutritional information, cooking classes, community gardening and other social capital building activities are needed for these women in order to avoid long-term health problems and help them better care for the next generation.

Trends in Australian contact lens prescribing during the first decade of the 21st Century (2000–2009)

Purpose: The aim was to document contact lens prescribing trends in Australia between 2000 and 2009. ---------- Methods: A survey of contact lens prescribing trends was conducted each year between 2000 and 2009. Australian optometrists were asked to provide information relating to 10 consecutive contact lens fittings between January and March each year. ---------- Results: Over the 10-year survey period, 1,462 practitioners returned survey forms representing a total of 13,721 contact lens fittings. The mean age (± SD) of lens wearers was 33.2 ± 13.6 years and 65 per cent were female. Between 2006 and 2009, rigid lens new fittings decreased from 18 to one per cent. Low water content lenses reduced from 11.5 to 3.2 per cent of soft lens fittings between 2000 and 2008. Between 2005 and 2009, toric lenses and multifocal lenses represented 26 and eight per cent, respectively, of all soft lenses fitted. Daily disposable, one- to two-week replacement and monthly replacement lenses accounted for 11.6, 30.0 and 46.5 per cent of all soft lens fittings over the survey period, respectively. The proportion of new soft fittings and refittings prescribed as extended wear has generally declined throughout the past decade. Multi-purpose lens care solutions dominate the market. Rigid lenses and monthly replacement soft lenses are predominantly worn on a full-time basis, whereas daily disposable soft lenses are mainly worn part-time.---------- Conclusions: This survey indicates that technological advances, such as the development of new lens materials, manufacturing methods and lens designs, and the availability of various lens replacement options, have had a significant impact on the contact lens market during the first decade of the 21st Century.

Daily disposable contact lens prescribing around the world

Daily disposable contact lenses were introduced into the market 16 years ago. Data that we have gathered from annual contact lens fitting surveys conducted in Australia, Canada, Japan, The Netherlands, Norway, the UK and the USA between 2000 and 2008 indicates an overall increase in daily disposable lens fitting during this period. Daily disposable lenses are especially popular in Japan, Norway and the UK. There is a trend for these lenses to be fitted on a part-time basis. Males are over-represented in daily disposable lens fitting—a trend that is especially evident in Canada. Daily disposable lens wearers are about two years younger than wearers of reusable lenses in Japan and The Netherlands. The convenience and health benefits of daily disposable lenses are expected to fuel continued growth in this sector.