Safety, feasibility and effects of an individualised walking intervention for women undergoing chemotherapy for ovarian cancer : a pilot study

Background: Exercise interventions during adjuvant cancer therapy have been shown to increase functional capacity, relieve fatigue and distress and may assist rates of chemotherapy completion. These studies have been limited to breast, gastric and mixed cancer groups and it is not yet known if a similar intervention is even feasible among women with ovarian cancer. We aimed to assess safety, feasibility and potential effect of a walking intervention in women undergoing chemotherapy for ovarian cancer. Methods: Women newly diagnosed with ovarian cancer were recruited to participate in an individualised walking intervention throughout chemotherapy and were assessed pre-and post-intervention. Feasibility measures included session adherence, compliance with exercise physiologist prescribed walking targets and self-reported program acceptability. Changes in objective physical functioning (6 minute walk test), self-reported distress (Hospital Anxiety and Depression Scale), symptoms (Memorial Symptom Assessment Scale - Physical) and quality of life (Functional Assessment of Cancer Therapy - Ovarian) were calculated, and chemotherapy completion and adverse intervention effects recorded. Results: Seventeen women were enrolled (63% recruitment rate). Mean age was 60 years (SD = 8 years), 88% were diagnosed with FIGO stage III or IV disease, 14 women underwent adjuvant and three neo-adjuvant chemotherapy. On average, women adhered to > 80% of their intervention sessions and complied with 76% of their walking targets, with the majority walking four days a week at moderate intensity for 30 minutes per session. Meaningful improvements were found in physical functioning, physical symptoms, physical well-being and ovarian cancerspecific quality of life. Most women (76%) completed ≥85% of their planned chemotherapy dose. There were no withdrawals or serious adverse events and all women reported the program as being helpful. Conclusions: These positive preliminary results suggest that this walking intervention for women receiving chemotherapy for ovarian cancer is safe, feasible and acceptable and could be used in development of future work. Trial registration: ACTRN12609000252213

A process evaluation of a comprehensive school based injury prevention program

A process evaluation enables understanding of critical issues that can inform the improved, ongoing implementation of an intervention program. This study describes the process evaluation of a comprehensive, multi-level injury prevention program for adolescents. The program targets change in injury associated with violence, transport and alcohol risks and incorporates two primary elements: an 8-week, teacher delivered attitude and behaviour change curriculum for Grade 8 students; and a professional development program for teachers on school level methods of protection, focusing on strategies to increase students’ connectedness to school.

An evaluation framework for assessing the impact of public bicycle share schemes

INTRODUCTION • Public bicycle share schemes have emerged as a method of increasing rates of bicycle riding. • The overwhelming majority of schemes have begun since 2005, taking advantage of various tracking and payment technologies making short term rental practical and affordable. • Very little research has been undertaken to determine their potentially broad impact on transport behaviour and consequently, it is difficult to understand the performance of these schemes in terms of reduced emissions and congestion, as well as possible increases in physical activity.

The influence of culture on safety : culture, organisational culture and safety culture

Transport and Storage Sector - Identified as one of 4 primary targets in the National Occupational Health and Safety Strategy 2002-2012 (NOHSS) The Heavy Vehicle Industry -80% of the freight task -29% of the employees in Transport and Storage 5 years on: -Transport and Storage - 22% reduction -Heavy Vehicle Industry - only an 11% reduction Intervention strategies that aren’t targeted to a specific audience may have differing levels of success due to cultural beliefs and values (McLeroy et al., 1994) Research Goal: - To explore the influence of culture on safety in the heavy vehicle industry

The role of education and awareness in workplace alcohol and drug use in the Australian construction industry : proposed program of research and preliminary results

The main aim of this paper is to outline a proposed program of research which will attempt to quantify the extent of the problem of alcohol and other drugs in the Australian construction industry, and furthermore, develop an appropriate industry-wide policy and cultural change management program and implementation plan to address the problem. This paper will also present preliminary results from the study. The study will use qualitative and quantitative methods (in the form of interviews and surveys, respectively) to evaluate the extent of the problem of alcohol and other drug use in this industry, to ascertain the feasibility of an industry-wide policy and cultural change management program, and to develop an appropriate implementation plan. The study will be undertaken in several construction organisations, at selected sites in South Australia, Victoria and Northern Territory. It is anticipated that approximately 500 employees from the participating organisations across Australia will take part in the study. The World Health Organisation’s Alcohol Use Disorders Identification Test (AUDIT) will be used to measure the extent of alcohol use in the industry. Illicit drug use, ‘‘readiness to change’’, impediments to reducing impairment, feasibility of proposed interventions, and employee attitudes and knowledge regarding workplace AOD impairment, will also be measured through a combination of interviews and surveys. Among the preliminary findings, for 51% (n=127) of respondents, score on the AUDIT indicated alcohol use at hazardous levels. Of the respondents who were using alcohol at hazardous levels, 76% reported (n97) that they do not have a problem with drinking and 54% (n=68) reported that it would be easy to ‘‘cut down’’ or stop drinking. Nearly half (49%) of all respondents (n=122) had used marijuana/cannabis at some time prior to being surveyed. The use of other illicit substances was much less frequently reported. Preliminary interview findings indicated a lack of adequate employee knowledge regarding the physical effects of alcohol and other drugs in the workplace. As for conclusions, the proposed study will address a major gap in the literature with regard to the extent of the problem of alcohol and other drug use in the construction industry in Australia. The study will also develop and implement a national, evidence-based workplace policy, with the aim of mitigating the deleterious effects of alcohol and other drugs in this industry.

Developing safer passengers through a school-based injury prevention program

Motor vehicle crashes are a leading cause of death among young people. Fourteen percent of adolescents aged 13-14 report passenger-related injuries within three months. Intervention programs typically focus on young drivers and overlook passengers as potential protective influences. Graduated Driver Licensing restricts passenger numbers, and this study focuses on a complementary school-based intervention to increase passengers’ personal- and peer-protective behavior. The aim of this research was to assess the impact of the curriculum-based injury prevention program, Skills for Preventing Injury in Youth (SPIY), on passenger-related risk-taking and injuries, and intentions to intervene in friends’ risky road behavior. SPIY was implemented in Grade 8 Health classes and evaluated using survey and focus group data from 843 students across 10 Australian secondary schools. Intervention students reported less passenger-related risk-taking six months following the program. Their intention to protect friends from underage driving also increased. The results of this study show that a comprehensive, school-based program targeting individual and social changes can increase adolescent passenger safety.

A case of community safety : displacing complex ‘social’ problems in Fortitude Valley

Public dialogue regarding the high concentration of drug use and crime in inner city locations is frequently legitimised through visibility of drug-using populations and a perception of high crime rates. The public space known as the Brunswick Street Mall (Valley mall), located in the inner city Brisbane suburb of Fortitude Valley, has long provided the focal point for discussions regarding the problem of illicit drug use and antisocial behaviour in Brisbane. During the late 1990s a range of stakeholders in Fortitude Valley became mobilised to tackle crime and illicit drugs. In particular they wanted to dismantle popular perceptions of the area as representing the dark and unsafe side of Brisbane. The aim of this campaign was to instil a sense of safety in the area and dislodge Fortitude Valley from its reputation as a =symbolic location of danger‘. This thesis is a case study about an urban site that became contested by the diverse aims of a range of stakeholders who were invested in an urban renewal program and community safety project. This case study makes visible a number of actors that were lured from their existing roles in an indeterminable number of heterogeneous networks in order to create a community safety network. The following analysis of the community safety network emphasises some specific actors: history, ideas, technologies, materialities and displacements. The case study relies on the work of Foucault, Latour, Callon and Law to draw out the rationalities, background contingencies and the attempts to impose order and translate a number of entities into the community safety project in Fortitude Valley. The results of this research show that the community safety project is a case of ontological politics. Specifically the data indicates that both the (reality) problem of safety and the (knowledge) solution to safety were created simultaneously. This thesis explores the idea that while violence continues to occur in the Valley, evidence that community safety got done is located through mapping its displacement and eventual disappearance. As such, this thesis argues that community safety is a =collateral reality‘.

The increased popularity of mopeds and motor scooters : exploring usage patterns and safety outcomes

Increased use of powered two-wheelers (PTWs) often underlies increases in the number of reported crashes, promoting research into PTW safety. PTW riders are overrepresented in crash and injury statistics relative to exposure and, as such, are considered vulnerable road users. PTW use has increased substantially over the last decade in many developed countries. One such country is Australia, where moped and scooter use has increased at a faster rate than motorcycle use in recent years. Increased moped use is particularly evident in the State of Queensland which is one of four Australian jurisdictions where moped riding is permitted for car licence holders and a motorcycle licence is not required. A moped is commonly a small motor scooter and is limited to a maximum design speed of 50 km/h and a maximum engine cylinder capacity of 50 cubic centimetres. Scooters exceeding either of these specifications are classed as motorcycles in all Australian jurisdictions. While an extensive body of knowledge exists on motorcycle safety, some of which is relevant to moped and scooter safety, the latter PTW types have received comparatively little focused research attention. Much of the research on moped safety to date has been conducted in Europe where they have been popular since the mid 20th century, while some studies have also been conducted in the United States. This research is of limited relevance to Australia due to socio-cultural, economic, regulatory and environmental differences. Moreover, while some studies have compared motorcycles to mopeds in terms of safety, no research to date has specifically examined the differences and similarities between mopeds and larger scooters, or between larger scooters and motorcycles. To address the need for a better understanding of moped and scooter use and safety, the current program of research involved three complementary studies designed to achieve the following aims: (1) develop better knowledge and understanding of moped and scooter usage trends and patterns; and (2) determine the factors leading to differences in moped, scooter and motorcycle safety. Study 1 involved six-monthly observations of PTW types in inner city parking areas of Queensland’s capital city, Brisbane, to monitor and quantify the types of PTW in use over a two year period. Study 2 involved an analysis of Queensland PTW crash and registration data, primarily comparing the police-reported crash involvement of mopeds, scooters and motorcycles over a five year period (N = 7,347). Study 3 employed both qualitative and quantitative methods to examine moped and scooter usage in two components: (a) four focus group discussions with Brisbane-based Queensland moped and scooter riders (N = 23); and (b) a state-wide survey of Queensland moped and scooter riders (N = 192). Study 1 found that of the PTW types parked in inner city Brisbane over the study period (N = 2,642), more than one third (36.1%) were mopeds or larger scooters. The number of PTWs observed increased at each six-monthly phase, but there were no significant changes in the proportions of PTW types observed across study phases. There were no significant differences in the proportions or numbers of PTW type observed by season. Study 2 revealed some important differences between mopeds, scooters and motorcycles in terms of safety and usage through analysis of crash and registration data. All Queensland PTW registrations doubled between 2001 and 2009, but there was an almost fifteen-fold increase in moped registrations. Mopeds subsequently increased as a proportion of Queensland registered PTWs from 1.2 percent to 8.8 percent over this nine year period. Moped and scooter crashes increased at a faster rate than motorcycle crashes over the five year study period from July 2003 to June 2008, reflecting their relatively greater increased usage. Crash rates per 10,000 registrations for the study period were only slightly higher for mopeds (133.4) than for motorcycles and scooters combined (124.8), but estimated crash rates per million vehicle kilometres travelled were higher for mopeds (6.3) than motorcycles and scooters (1.7). While the number of crashes increased for each PTW type over the study period, the rate of crashes per 10,000 registrations declined by 40 percent for mopeds compared with 22 percent for motorcycles and scooters combined. Moped and scooter crashes were generally less severe than motorcycle crashes and this was related to the particular crash characteristics of the PTW types rather than to the PTW types themselves. Compared to motorcycle and moped crashes, scooter crashes were less likely to be single vehicle crashes, to involve a speeding or impaired rider, to involve poor road conditions, or to be attributed to rider error. Scooter and moped crashes were more likely than motorcycle crashes to occur on weekdays, in lower speed zones and at intersections. Scooter riders were older on average (39) than moped (32) and motorcycle (35) riders, while moped riders were more likely to be female (36%) than scooter (22%) or motorcycle riders (7%). The licence characteristics of scooter and motorcycle riders were similar, with moped riders more likely to be licensed outside of Queensland and less likely to hold a full or open licence. The PTW type could not be identified in 15 percent of all cases, indicating a need for more complete recording of vehicle details in the registration data. The focus groups in Study 3a and the survey in Study 3b suggested that moped and scooter riders are a heterogeneous population in terms of demographic characteristics, riding experience, and knowledge and attitudes regarding safety and risk. The self-reported crash involvement of Study 3b respondents suggests that most moped and scooter crashes result in no injury or minor injury and are not reported to police. Study 3 provided some explanation for differences observed in Study 2 between mopeds and scooters in terms of crash involvement. On the whole, scooter riders were older, more experienced, more likely to have undertaken rider training and to value rider training programs. Scooter riders were also more likely to use protective clothing and to seek out safety-related information. This research has some important practical implications regarding moped and scooter use and safety. While mopeds and scooters are generally similar in terms of usage, and their usage has increased, scooter riders appear to be safer than moped riders due to some combination of superior skills and safer riding behaviour. It is reasonable to expect that mopeds and scooters will remain popular in Queensland in future and that their usage may further increase, along with that of motorcycles. Future policy and planning should consider potential options for encouraging moped riders to acquire better riding skills and greater safety awareness. While rider training and licensing appears an obvious potential countermeasure, the effectiveness of rider training has not been established and other options should also be strongly considered. Such options might include rider education and safety promotion, while interventions could also target other road users and urban infrastructure. Future research is warranted in regard to moped and scooter safety, particularly where the use of those PTWs has increased substantially from low levels. Research could address areas such as rider training and licensing (including program evaluations), the need for more detailed and reliable data (particularly crash and exposure data), protective clothing use, risks associated with lane splitting and filtering, and tourist use of mopeds. Some of this research would likely be relevant to motorcycle use and safety, as well as that of mopeds and scooters.

Barriers and facilitators to public bicycle scheme use : a qualitative approach

The purpose of this study was to explore barriers and facilitators to using CityCycle, a public bicycle share scheme in Brisbane, Australia. Focus groups were conducted with participants belonging to one of three categories. Group one consisted of infrequent and noncyclists (no bicycle riding over the past month), group two were regular bicycle riders (ridden a bicycle at least once in the past month) and group three was composed of CityCycle members. A thematic analytic method was used to analyse the data. Three main themes were found: Accessibility/spontaneity, safety and weather/topography. The lengthy sign-up process was thought to stifle the spontaneity typically thought to attract people to public bike share. Mandatory helmet legislation was thought to reduce spontaneous use. Safety was a major concern for all groups and this included a perceived lack of suitable bicycle infrastructure, as well as regular riders describing a negative attitude of some car drivers. Interestingly, CityCycle riders unanimously perceived car driver attitudes to improve when on CityCycle bicycles relative to riding on personal bicycles. Conclusions: In order to increase the popularity of the CityCycle scheme, the results of this study suggest that a more accessible, spontaneous sign-up process is required, 24/7 opening hours, and greater incentives to sign up new members and casual users, as seeing people using CityCycle appears critical to further take up.

The experiences of parents and other supervisors in a graduated driver licensing program in Queensland, Australia

Study Aims Describe how parents and other private supervisors have responded to the changes made to the Queensland graduated driver licensing system in mid-2007 Examine differences in the experiences and perceptions of the parents and non-parents Method Combination of convenience and snowball sampling Survey administered by the internet Survey conducted between July 2009 and May 2010 Approximately 15-20 minutes to complete $20 reimbursement for participation

Understanding the fear of bicycle riding in Australia

Rates of bicycle commuting currently hover around 1 - 2% in most Australian capital cities, although 17.8% of Australians report riding at least once per week. The most commonly stated reason for choosing not to ride a bicycle is fear of motorised vehicles. This paper sets out to examine the literature and offer a commentary regarding the role fear plays as a barrier to bicycle riding. The paper also provides an estimate of the relative risk of driving and riding, on a per trip basis. An analysis of the existing literature finds fear of motorised traffic to be disproportionate to actual levels of risk to bicycle riders. Moreover, the health benefits of bicycling outweigh the risks of collision. Rather than actual collisions forming the basis of people’s fear, it appears plausible that near collisions (which occur far more frequently) may be a significant cause for the exaggerated levels of fear associated with bicycle riding. In order to achieve the Australian Government’s goal of doubling bike riding participation, this review suggests it will be necessary to counter fear through the creation of a low risk traffic environment (both perceived and real), involving marketing/promotional campaigns and the development of a comprehensive bicycle infrastructure network and lower speed limits.

Development of a school connectedness component of an adolescent injury prevention program : lessons for implementation

The school environment plays an important role in shaping adolescent outcomes, and research increasingly demonstrates the need to target the school social context in health promotion programs. This paper describes the research process undertaken to design a school connectedness component of an injury prevention program for early adolescents, Skills for Preventing Injury in Youth (SPIY). The connectedness component takes the form of a professional development workshop for teachers on increasing students’ connectedness to school, and this paper describes the research process used to construct program material. It also describes the methods used to encourage teachers’ implementation of connectedness strategies following program delivery. A multi-stage process of data collection included, (i) surveys with 540 Grade 9 students to examine links between school connectedness and risk-related injury, (ii) a systematic literature review of previously-evaluated school connectedness programs to determine key strategies that encourage implementation fidelity and program effectiveness, and (iii) interviews with 14 high school teachers to understand current use of connectedness strategies and ideas for program design. Findings from each stage are discussed in terms of how results informed the program design. The survey data provided information from which to frame program content, and the results of the systematic review demonstrated effective program strategies. The teacher interview data also provided program content incorporating target participants’ views and aligning with their priorities, which is important to ensure effective implementation of program strategies. A comprehensive design process provides an understanding of methods for, and may encourage, teachers’ future implementation of program strategies.

Reaching high-risk adolescents : a process evaluation of a school based injury prevention program

High-risk adolescents are a population most vulnerable to harm from injury due to increased engagement in risk taking behaviour. There is a gap in the literature regarding how universal school based injury prevention programs apply to high-risk adolescents. This study involves a component of the process evaluation of a school based injury prevention program, as it relates to high-risk adolescents (13-14 years)...

The impact of an enhanced graduated driver licensing program in Queensland

The Queensland graduated driver licensing (GDL) context (post-July 2007) - The experiences of young Learner drivers - Comparison of pre- (‘Original-GDL’) and post-July 2007 (‘Enhanced-GDL’) experiences - Post-July 2007 experiences - GDL-related issues - Other factors in young novice driver safety - Person-related factors - Social factors