The current workforce status of prehospital care in China

Abstract The Chinese Emergency Medicine System is primarily composed of three sectors; prehospital care, emergency department in a city hospital, and intensive care unit ward. While all sectors are integral to the system, the prehospital care system is less developed than the others. There are many possible contributors to the under-development of the prehospital care system, however, workforce issues may play a significant role. Firstly, there is no officially recognised paramedic profession in China. The staff members working in the prehospital care system are medical doctors, registered nurses, patient-carriers, and drivers. Secondly, these doctors and nurses are either over-qualified or under-qualified for practicing in the prehospital care system. Lastly, Chinese health professionals have taken actions to improve the current workforce status with initiatives such as short-term training workshops for doctors and nurses, implementation of a trial unit in a university, and development of a Major Degree of Emergency Medicine in a medical university. All of these actions are important steps toward improving the current workforce status in the prehospital care system. However, a long term workforce development plan is still essential for the Chinese system, and implementation of a professional paramedic education system in a medical university/college in China, may provide the solution. Keywords: China; emergency medicine system; health services; prehospital care system; workforce; service delivery

Beyond barcoding : a mitochondrial genomics approach to molecular phylogenetics and diagnostics of blowflies (Diptera: Calliphoridae)

Members of the Calliphoridae (blowflies) are significant for medical and veterinary management, due to the ability of some species to consume living flesh as larvae, and for forensic investigations due to the ability of others to develop in corpses. Due to the difficulty of accurately identifying larval blowflies to species there is a need for DNA-based diagnostics for this family, however the widely used DNA-barcoding marker, cox1, has been shown to fail for several groups within this family. Additionally, many phylogenetic relationships within the Calliphoridae are still unresolved, particularly deeper level relationships. Sequencing whole mt genomes has been demonstrated both as an effective method for identifying the most informative diagnostic markers and for resolving phylogenetic relationships. Twenty-seven complete, or nearly so, mt genomes were sequenced representing 13 species, seven genera and four calliphorid subfamilies and a member of the related family Tachinidae. PCR and sequencing primers developed for sequencing one calliphorid species could be reused to sequence related species within the same superfamily with success rates ranging from 61% to 100%, demonstrating the speed and efficiency with which an mt genome dataset can be assembled. Comparison of molecular divergences for each of the 13 protein-coding genes and 2 ribosomal RNA genes, at a range of taxonomic scales identified novel targets for developing as diagnostic markers which were 117–200% more variable than the markers which have been used previously in calliphorids. Phylogenetic analysis of whole mt genome sequences resulted in much stronger support for family and subfamily-level relationships. The Calliphoridae are polyphyletic, with the Polleninae more closely related to the Tachinidae, and the Sarcophagidae are the sister group of the remaining calliphorids. Within the Calliphoridae, there was strong support for the monophyly of the Chrysomyinae and Luciliinae and for the sister-grouping of Luciliinae with Calliphorinae. Relationships within Chrysomya were not well resolved. Whole mt genome data, supported the previously demonstrated paraphyly of Lucilia cuprina with respect to L. sericata and allowed us to conclude that it is due to hybrid introgression prior to the last common ancestor of modern sericata populations, rather than due to recent hybridisation, nuclear pseudogenes or incomplete lineage sorting.

How males and females define speeding and how they’d feel getting caught for it : some implications for anti-speeding message development

Speeding represents a major contributor to road trauma, increasing crash frequency and severity. Antispeeding campaigns represent a key strategy aimed at discouraging individuals from speeding. This paper investigated salient beliefs underpinning male and female drivers’ travel speed behaviour, with the view to use such insight to, ultimately, inform the content of targeted anti-speeding messages. A survey of N = 751 (579 males, 16-79 years) drivers assessed what they regarded as speeding in 60km/hr and 100km/hr zones and their beliefs about how they would respond to receiving a speeding infringement. Participants responded to scales which extended up to 20km/hr above each respective speed limit, the lowest speed that they considered was speeding and the speed at which they would be willing to drive and still feel in control. For analyses, to enable greater scrutiny of potential gender differences regarding the speeds identified, participants’ responses to these items were categorised into 5km/hr increments and chi-square analyses conducted. For their responses to (beliefs about) the possibility of being caught speeding, drivers were asked how applicable various beliefs were to them (e.g., feeling unlucky). These beliefs were analysed via MANOVA. The results revealed that there was considerable variability in the speeds identified, thus supporting the value of categorising speeds. Within the 100km/hr zone, based on the categories, a significant difference was found regarding the speed that males would be willing to drive (and still feel in control) relative to females. Specifically, the greatest proportion of males (30.4%) identified speeds within the 106-110km/hr category whereas the greatest proportion of females (38.1%) identified a lower speed, within the 101-105km/hr category, as the speed they would be willing to drive. No other significant differences emerged, however, either in relation to the definition of speeding reported for 100km/hr zones (i.e., males and females tended to identify a similar speed as indicative of speeding) nor for these same items as assessed in relation to the 60km/hr zones. For their responses to the possibility of being caught, males were significantly more likely than females to report that, if caught, a likely response they would have would be to think that they had still been driving safely. In contrast, females were significantly more likely than males to report thinking that their speeding had been unsafe and that they should not have been speeding. Females were also significantly more likely to report feeling embarrassed to tell important others about having received a speeding infringement than males. The findings are discussed in terms of their implications for developing well-targeted advertising messages aimed at discouraging drivers’ from speeding.

"Are there any right or wrong answers in teaching philosophy": ethics, epistemology, and philosophy in the classroom

This article assesses undergraduate teaching students’ assertion that there are no right and wrong answers in teaching philosophy. When asked questions about their experiences of philosophy in the classroom for primary children, their unanimous declaration that teaching philosophy has ‘no right and wrong answers’ is critically examined across the three sub-disciplinary areas to which they were generally referring, namely, pedagogy, ethics, and epistemology. From a pedagogical point of view, it is argued that some teaching approaches may indeed be more effective than others, and some pupils’ opinions less defensible, but pedagogically, in terms of managing the power relations in the classroom, it is counter-productive to continually insist on notions of truth and falsity at every point. From an ethical point of view, it is contended that anti-realist approaches to meta-ethics may represent a viable intellectual position, but from the point of view of normative ethics, notions of right and wrong still retain significant currency. From an epistemological point of view, it is argued using Karl Poppers’ work that while it may be difficult to determine what constitutes a right answer, determining a wrong one is far more straightforward. In conclusion, it is clear that prospective teachers engaging in philosophy in the classroom, and also future teachers in general, require a far more nuanced philosophical understanding of the notions of right and wrong and truth and falsity. In view of this situation, it we wish to promote the effective teaching of philosophical thinking to children, or produce educators who can understand the conceptual limits of the claims they make and their very real and often serious practical and social consequences, it is recommended that philosophy be reinstated to a fundamental, foundational place within the pre-service teaching curriculum.

Trace phases in CI chondrites Alais and Orgueil

Minor phases in meteorites are important indicators of parent-body processing conditions. For example, Kerridge and others (1, 2) have shown that the presence of sulphates and carbonates in CI chondrites provides evidence for aqueous alteration on the parent body. Carbonates and sulphates are relatively prominent components of CI chondrites (e.g., -11.6 wt.% of total mass' and> 10 um diameter) compared to minor phases in most other classes of meteorite and thus, have been amenable to macro scale characterisation using optical petrography and electron microprobe analysis. These minor phases account for significant accumulations of low abundance elements, such as Na, S, K, Ca, and Ni within the bulk meteorite. The fine grained matrix, which consists mostly oflizardite- and montmorillonite-like clays (3), is the...

A critical regionalist approach to housing design in Vietnam : socio-environmental organisation of living spaces in pre- and post-reform houses

Vietnam has a unique culture which is revealed in the way that people have built and designed their traditional housing. Vietnamese dwellings reflect occupants’ activities in their everyday lives, while adapting to tropical climatic conditions impacted by seasoning monsoons. It is said that these characteristics of Vietnamese dwellings have remained unchanged until the economic reform in 1986, when Vietnam experienced an accelerated development based on the market-oriented economy. New housing types, including modern shop-houses, detached houses, and apartments, have been designed in many places, especially satisfying dwellers’ new lifestyles in Vietnamese cities. The contemporary housing, which has been mostly designed by architects, has reflected rules of spatial organisation so that occupants’ social activities are carried out. However, contemporary housing spaces seem unsustainable in relation to socio-cultural values because they has been influenced by globalism that advocates the use of homogeneous spatial patterns, modern technologies, materials and construction methods. This study investigates the rules of spaces in Vietnamese houses that were built before and after the reform to define the socio-cultural implications in Vietnamese housing design. Firstly, it describes occupants’ views of their current dwellings in terms of indoor comfort conditions and social activities in spaces. Then, it examines the use of spaces in pre-reform Vietnamese housing through occupants’ activities and material applications. Finally, it discusses the organisation of spaces in both pre- and post-reform housing to understand how Vietnamese housing has been designed for occupants to live, act, work, and conduct traditional activities. Understanding spatial organisation is a way to identify characteristics of the lived spaces of the occupants created from the conceived space, which is designed by designers. The characteristics of the housing spaces will inform the designers the way to design future Vietnamese housing in response to cultural contexts. The study applied an abductive approach for the investigation of housing spaces. It used a conceptual framework in relation to Henri Lefebvre’s (1991) theory to understand space as the main factor constituting the language of design, and the principles of semiotics to examine spatial structure in housing as a language used in the everyday life. The study involved a door-knocking survey to 350 households in four regional cities of Vietnam for interpretation of occupancy conditions and levels of occupants’ comfort. A statistical analysis was applied to interpret the survey data. The study also required a process of data selection and collection of fourteen cases of housing in three main climatic regions of the country for analysing spatial organisation and housing characteristics. The study found that there has been a shift in the relationship of spaces from the pre- to post-reform Vietnamese housing. It also indentified that the space for guest welcoming and family activity has been the central space of the Vietnamese housing. Based on the relationships of the central space with the others, theoretical models were proposed for three types of contemporary Vietnamese housing. The models will be significant in adapting to Vietnamese conditions to achieve socioenvironmental characteristics for housing design because it was developed from the occupants’ requirements for their social activities. Another contribution of the study is the use of methodological concepts to understand the language of living spaces. Further work will be needed to test future Vietnamese housing designs from the applications of the models.

Diurnal temperature range and childhood asthma : a time-series study

BACKGROUND: Hot and cold temperatures have been associated with childhood asthma. However, the relationship between daily temperature variation and childhood asthma is not well understood. This study aimed to examine the relationship between diurnal temperature range (DTR) and childhood asthma. METHODS: A Poisson generalized linear model combined with a distributed lag non-linear model was used to examine the relationship between DTR and emergency department admissions for childhood asthma in Brisbane, from January 1st 2003 to December 31st 2009. RESULTS: There was a statistically significant relationship between DTR and childhood asthma. The DTR effect on childhood asthma increased above a DTR of 10[degree sign]C. The effect of DTR on childhood asthma was the greatest for lag 0--9 days, with a 31% (95% confidence interval: 11% -- 58%) increase of emergency department admissions per 5[degree sign]C increment of DTR. Male children and children aged 5--9 years appeared to be more vulnerable to the DTR effect than others. CONCLUSIONS: Large DTR may trigger childhood asthma. Future measures to control and prevent childhood asthma should include taking temperature variability into account. More protective measures should be taken after a day of DTR above10[degree sign]C.

Paleomagnetic data support Early Permian age for the Abor Volcanics in the lower Siang Valley, NE India; significance for Gondwana-related break-up models

Confusion exists as to the age of the Abor Volcanics of NE India. Some consider the unit to have been emplaced in the Early Permian, others the Early Eocene, a difference of ∼230 million years. The divergence in opinion is significant because fundamentally different models explaining the geotectonic evolution of India depend on the age designation of the unit. Paleomagnetic data reported here from several exposures in the type locality of the formation in the lower Siang Valley indicate that steep dipping primary magnetizations (mean = 72.7 ± 6.2°, equating to a paleo-latitude of 58.1°) are recorded in the formation. These are only consistent with the unit being of Permian age, possibly Artinskian based on a magnetostratigraphic argument. Plate tectonic models for this time consistently show the NE corner of the sub-continent >50°S; in the Early Eocene it was just north of the equator, which would have resulted in the unit recording shallow directions. The mean declination is counter-clockwise rotated by ∼94°, around half of which can be related to the motion of the Indian block; the remainder is likely due local Himalayan-age thrusting in the Eastern Syntaxis. Several workers have correlated the Abor Volcanics with broadly coeval mafic volcanic suites in Oman, NE Pakistan–NW India and southern Tibet–Nepal, which developed in response to the Cimmerian block peeling-off eastern Gondwana in the Early-Middle Permian, but we believe there are problems with this model. Instead, we suggest that the Abor basalts relate to India–Antarctica/India–Australia extension that was happening at about the same time. Such an explanation best accommodates the relevant stratigraphical and structural data (present-day position within the Himalayan thrust stack), as well as the plate tectonic model for Permian eastern Gondwana.

The decline in activities of daily living at discharge (DADLD) index : stratifying patients at lower and higher risk

Background: Decreased ability to perform Activities of Daily Living (ADLs) during hospitalisation has negative consequences for patients and health service delivery. Objective: To develop an Index to stratify patients at lower and higher risk of a significant decline in ability to perform ADLs at discharge. Design: Prospective two cohort study comprising a derivation (n=389; mean age 82.3 years; SD� 7.1) and a validation cohort (n=153; mean age 81.5 years; SD� 6.1). Patients and setting: General medical patients aged = 70 years admitted to three university-affiliated acute care hospitals in Brisbane, Australia. Measurement and main results: The short ADL Scale was used to identify a significant decline in ability to perform ADLs from premorbid to discharge. In the derivation cohort, 77 patients (19.8%) experienced a significant decline. Four significant factors were identified for patients independent at baseline: 'requiring moderate assistance to being totally dependent on others with bathing'; 'difficulty understanding others (frequently or all the time)'; 'requiring moderate assistance to being totally dependent on others with performing housework'; a 'history of experiencing at least one fall in the previous 90 days prior to hospital admission' in addition to 'independent at baseline', which was protective against decline at discharge. 'Difficulty understanding others (frequently or all the time)' and 'requiring moderate assistance to being totally dependent on others with performing housework' were also predictors for patients dependent in ADLs at baseline. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of the DADLD dichotomised risk scores were: 83.1% (95% CI 72.8; 90.7); 60.5% (95% CI 54.8; 65.9); 34.2% (95% CI 27.5; 41.5); 93.5% (95% CI 89.2; 96.5). In the validation cohort, 47 patients (30.7%) experienced a significant decline. Sensitivity, specificity, PPV and NPV of the DADLD were: 78.7% (95% CI 64.3; 89.3); 69.8% (95% CI 60.1, 78.3); 53.6% (95% CI 41.2; 65.7); 88.1% (95% CI 79.2; 94.1). Conclusions: The DADLD Index is a useful tool for identifying patients at higher risk of decline in ability to perform ADLs at discharge.

Evaluating the effectiveness of heat warning systems : a systematic review of epidemiological evidence

Objectives To review the existing research on the effectiveness of heat warning systems (HWSs) in saving lives and reducing harm. Methods A systematic search of major databases was conducted, using “heat, heatwave, high temperature, hot temperature, OR hot climate” AND “warning system”. Results Fifteen articles were retrieved. Six studies asserted that fewer people died of excessive heat after HWS implementation. HWS was associated with reduction in ambulance use. One study estimated the benefits of HWS to be 468millionforsaving117livescomparedto210,000 costs of running the system. Eight studies showed that mere availability of HWS did not lead to behavioral changes. Perceived threat of heat dangers to self/others was the main factor related to heeding warnings and taking proper actions. However, costs and barriers associated with taking protective actions, such as costs of running air conditioners, were of significant concern particularly to the poor. Conclusions Research in this area is limited. Prospective designs applying health behavior theories should establish whether HWS can produce the health benefits they are purported to achieve by identifying the target vulnerable groups.

"They did not believe me" : Adult survivors' perspectives of child sexual abuse by personnel in Christian Institutions

Executive Summary Child sexual abuse (CSA) in Christian Institutions continues to be of serious concern in public, criminal justice and institutional discourse. This study was conducted in conjunction with Project Kidsafe Foundation and sought the perspectives of Australian survivors of CSA by Personnel in Christian Institutions (PICIs). In total, 81 individual survivors responded to an online survey which asked them a range of questions about their current and childhood life circumstance; the nature, extent and location of abuse; grooming strategies utilised by perpetrators; their experiences of disclosure; and outcomes of official reporting to both criminal justice agencies and also official processes Christian institutions. Survey participants were given the option to further participate in a qualitative interview with the principal researcher. These interviews are not considered within this report. In summary, survey data examined here indicate that: • Instances of abuse included a range of offences from touching outside of clothing to serious penetrative offences. • The onset of abuse occurred at a young age: between 6 and 10 years for most female participants, and 11 and 13 years for male participants. • In the majority of cases the abuse ceased because of actions by survivors, not by adults within families or the Christian institution. • Participants waited significant time before disclosing their abuse, with many waiting 20 years or more. • Where survivors disclosed to family members or PICIs, they were often met with disbelief and unhelpful responses aimed at minimising the harm. • Where an official report was made, it was most often made to police. In these cases 53% resulted in an official investigations. • The primary reasons for reporting were to protect others from the perpetrator and make the Christian institution accountable to an external agency. • Where reports to Christian institutions were made, most survivors were dissatisfied with outcomes, and a smaller majority was extremely dissatisfied. This report reflects the long-held understanding that responding to CSA is a complex and difficult task. If effective and meaningful responses are not made, however, trauma to the survivor is most often compounded and recovery delayed. This report demonstrates the need for further independent analysis and oversight of responses made to CSA by both criminal justice, religious and social institutions. Meaningful change will only be accessible, however, if family, community and institutional environments are safe places for survivors to disclose their experiences of abuse and begin to seek ways of healing. There is much to be learnt from survivors that have already made this journey.

A comprehensive investigation of the risky driving behaviour of young novice drivers

Young novice drivers - that is, drivers aged 16-25 years who are relatively inexperienced in driving on the road and have a novice (Learner, Provisional) driver's licence - have been overrepresented in car crash, injury and fatality statistics around the world for decades. There are numerous persistent characteristics evident in young novice driver crashes, fatalities and offences, including variables relating to the young driver themselves, broader social influences which include their passengers, the car they drive, and when and how they drive, and their risky driving behaviour in particular. Moreover, there are a range of psychosocial factors influencing the behaviour of young novice drivers, including the social influences of parents and peers, and person-related factors such as age-related factors, attitudes, and sensation seeking. Historically, a range of approaches have been developed to manage the risky driving behaviour of young novice drivers. Traditional measures predominantly relying upon education have had limited success in regulating the risky driving behaviour of the young novice driver. In contrast, interventions such as graduated driver licensing (GDL) which acknowledges young novice drivers' limitations - principally pertaining to their chronological and developmental age, and their driving inexperience - have shown to be effective in ameliorating this pervasive public health problem. In practice, GDL is a risk management tool that is designed to reduce driving at risky times (e.g., at night) or in risky driving conditions (e.g., with passengers), while still enabling novice drivers to obtain experience. In this regard, the GDL program in Queensland, Australia, was considerably enhanced in July 2007, and major additions to the program include mandated Learner practice of 100 hours recorded in a logbook, and passenger limits during night driving in the Provisional phase. Road safety researchers have also continued to consider the influential role played by the young driver's psychosocial characteristics, including psychological traits and states. In addition, whilst the majority of road safety user research is epidemiological in nature, contemporary road safety research is increasingly applying psychological and criminological theories. Importantly, such theories not only can guide young novice driver research, they can also inform the development and evaluation of countermeasures targeting their risky driving behaviour. The research is thus designed to explore the self-reported behaviours - and the personal, psychosocial, and structural influences upon the behaviours - of young novice drivers This thesis incorporates three stages of predominantly quantitative research to undertake a comprehensive investigation of the risky driving behaviour of young novices. Risky driving behaviour increases the likelihood of the young novice driver being involved in a crash which may harm themselves or other road users, and deliberate risky driving such as driving in excess of the posted speed limits is the focus of the program of research. The extant literature examining the nature of the risky behaviour of the young novice driver - and the contributing factors for this behaviour - while comprehensive, has not led to the development of a reliable instrument designed specifically to measure the risky behaviour of the young novice driver. Therefore the development and application of such a tool (the Behaviour of Young Novice Drivers Scale, or BYNDS) was foremost in the program of research. In addition to describing the driving behaviours of the young novice, a central theme of this program of research was identifying, describing, and quantifying personal, behavioural, and environmental influences upon young novice driver risky behaviour. Accordingly the 11 papers developed from the three stages of research which comprise this thesis are framed within Bandura's reciprocal determinism model which explicitly considers the reciprocal relationship between the environment, the person, and their behaviour. Stage One comprised the foundation research and operationalised quantitative and qualitative methodologies to finalise the instrument used in Stages Two and Three. The first part of Stage One involved an online survey which was completed by 761 young novice drivers who attended tertiary education institutions across Queensland. A reliable instrument for measuring the risky driving behaviour of young novices was developed (the BYNDS) and is currently being operationalised in young novice driver research in progress at the Centre for Injury Research and Prevention in Philadelphia, USA. In addition, regression analyses revealed that psychological distress influenced risky driving behaviour, and the differential influence of depression, anxiety, sensitivity to punishments and rewards, and sensation seeking propensity were explored. Path model analyses revealed that punishment sensitivity was mediated by anxiety and depression; and the influence of depression, anxiety, reward sensitivity and sensation seeking propensity were moderated by the gender of the driver. Specifically, for males, sensation seeking propensity, depression, and reward sensitivity were predictive of self-reported risky driving, whilst for females anxiety was also influential. In the second part of Stage One, 21 young novice drivers participated in individual and small group interviews. The normative influences of parents, peers, and the Police were explicated. Content analysis supported four themes of influence through punishments, rewards, and the behaviours and attitudes of parents and friends. The Police were also influential upon the risky driving behaviour of young novices. The findings of both parts of Stage One informed the research of Stage Two. Stage Two was a comprehensive investigation of the pre-Licence and Learner experiences, attitudes, and behaviours, of young novice drivers. In this stage, 1170 young novice drivers from across Queensland completed an online or paper survey exploring their experiences, behaviours and attitudes as a pre- and Learner driver. The majority of novices did not drive before they were licensed (pre-Licence driving) or as an unsupervised Learner, submitted accurate logbooks, intended to follow the road rules as a Provisional driver, and reported practicing predominantly at the end of the Learner period. The experience of Learners in the enhanced-GDL program were also examined and compared to those of Learner drivers who progressed through the former-GDL program (data collected previously by Bates, Watson, & King, 2009a). Importantly, current-GDL Learners reported significantly more driving practice and a longer Learner period, less difficulty obtaining practice, and less offence detection and crash involvement than Learners in the former-GDL program. The findings of Stage Two informed the research of Stage Three. Stage Three was a comprehensive exploration of the driving experiences, attitudes and behaviours of young novice drivers during their first six months of Provisional 1 licensure. In this stage, 390 of the 1170 young novice drivers from Stage Two completed another survey, and data collected during Stages Two and Three allowed a longitudinal investigation of self-reported risky driving behaviours, such as GDL-specific and general road rule compliance; risky behaviour such as pre-Licence driving, crash involvement and offence detection; and vehicle ownership, paying attention to Police presence, and punishment avoidance. Whilst the majority of Learner and Provisional drivers reported compliance with GDL-specific and general road rules, 33% of Learners and 50% of Provisional drivers reported speeding by 10-20 km/hr at least occasionally. Twelve percent of Learner drivers reported pre-Licence driving, and these drivers were significantly more risky as Learner and Provisional drivers. Ten percent of males and females reported being involved in a crash, and 10% of females and 18% of males had been detected for an offence, within the first six months of independent driving. Additionally, 75% of young novice drivers reported owning their own car within six months of gaining their Provisional driver's licence. Vehicle owners reported significantly shorter Learner periods and more risky driving exposure as a Provisional driver. Paying attention to Police presence on the roads appeared normative for young novice drivers: 91% of Learners and 72% of Provisional drivers reported paying attention. Provisional drivers also reported they actively avoided the Police: 25% of males and 13% of females; 23% of rural drivers and 15% of urban drivers. Stage Three also allowed the refinement of the risky behaviour measurement tool (BYNDS) created in Stage One; the original reliable 44-item instrument was refined to a similarly reliable 36-item instrument. A longitudinal exploration of the influence of anxiety, depression, sensation seeking propensity and reward sensitivity upon the risky behaviour of the Provisional driver was also undertaken using data collected in Stages Two and Three. Consistent with the research of Stage One, structural equation modeling revealed anxiety, reward sensitivity and sensation seeking propensity predicted self-reported risky driving behaviour. Again, gender was a moderator, with only reward sensitivity predicting risky driving for males. A measurement model of Akers' social learning theory (SLT) was developed containing six subscales operationalising the four constructs of differential association, imitation, personal attitudes, and differential reinforcement, and the influence of parents and peers was captured within the items in a number of these constructs. Analyses exploring the nature and extent of the psychosocial influences of personal characteristics (step 1), Akers' SLT (step 2), and elements of the prototype/willingness model (PWM) (step 3) upon self-reported speeding by the Provisional driver in a hierarchical multiple regression model found the following significant predictors: gender (male), car ownership (own car), reward sensitivity (greater sensitivity), depression (greater depression), personal attitudes (more risky attitudes), and speeding (more speeding) as a Learner. The research findings have considerable implications for road safety researchers, policy-makers, mental health professionals and medical practitioners alike. A broad range of issues need to be considered when developing, implementing and evaluating interventions for both the intentional and unintentional risky driving behaviours of interest. While a variety of interventions have been historically utilised, including education, enforcement, rehabilitation and incentives, caution is warranted. A multi-faceted approach to improving novice road safety is more likely to be effective, and new and existing countermeasures should capitalise on the potential of parents, peers and Police to be a positive influence upon the risky behaviour of young novice drivers. However, the efficacy of some interventions remains undetermined at this time. Notwithstanding this caveat, countermeasures such as augmenting and strengthening Queensland's GDL program and targeting parents and adolescents particularly warrant further attention. The findings of the research program suggest that Queensland's current-GDL can be strengthened by increasing compliance of young novice drivers with existing conditions and restrictions. The rates of speeding reported by the young Learner driver are particularly alarming for a number of reasons. The Learner is inexperienced in driving, and travelling in excess of speed limits places them at greater risk as they are also inexperienced in detecting and responding appropriately to driving hazards. In addition, the Learner period should provide the foundation for a safe lifetime driving career, enabling the development and reinforcement of non-risky driving habits. Learners who sped reported speeding by greater margins, and at greater frequencies, when they were able to drive independently. Other strategies could also be considered to enhance Queensland's GDL program, addressing both the pre-Licence adolescent and their parents. Options that warrant further investigation to determine their likely effectiveness include screening and treatment of novice drivers by mental health professionals and/or medical practitioners; and general social skills training. Considering the self-reported pre-licence driving of the young novice driver, targeted education of parents may need to occur before their child obtains a Learner licence. It is noteworthy that those participants who reported risky driving during the Learner phase also were more likely to report risky driving behaviour during the Provisional phase; therefore it appears vital that the development of safe driving habits is encouraged from the beginning of the novice period. General education of parents and young novice drivers should inform them of the considerably-increased likelihood of risky driving behaviour, crashes and offences associated with having unlimited access to a vehicle in the early stages of intermediate licensure. Importantly, parents frequently purchase the car that is used by the Provisional driver, who typically lives at home with their parents, and therefore parents are ideally positioned to monitor the journeys of their young novice driver during this early stage of independent driving. Parents are pivotal in the development of their driving child: they are models who are imitated and are sources of attitudes, expectancies, rewards and punishments; and they provide the most driving instruction for the Learner. High rates of self-reported speeding by Learners suggests that GDL programs specifically consider the nature of supervision during the Learner period, encouraging supervisors to be vigilant to compliance with general and GDL-specific road rules, and especially driving in excess of speed limit. Attitudes towards driving are formed before the adolescent reaches the age when they can be legally licensed. Young novice drivers with risky personal attitudes towards driving reported more risky driving behaviour, suggesting that countermeasures should target such attitudes and that such interventions might be implemented before the adolescent is licensed. The risky behaviours and attitudes of friends were also found to be influential, and given that young novice drivers tend to carry their friends as their passengers, a group intervention such as provided in a school class context may prove more effective. Social skills interventions that encourage the novice to resist the negative influences of their friends and their peer passengers, and to not imitate the risky driving behaviour of their friends, may also be effective. The punishments and rewards anticipated from and administered by friends were also found to influence the self-reported risky behaviour of the young novice driver; therefore young persons could be encouraged to sanction the risky, and to reward the non-risky, driving of their novice friends. Adolescent health programs and related initiatives need to more specifically consider the risks associated with driving. Young novice drivers are also adolescents, a developmental period associated with depression and anxiety. Depression, anxiety, and sensation seeking propensity were found to be predictive of risky driving; therefore interventions targeting psychological distress, whilst discouraging the expression of sensation seeking propensity whilst driving, warrant development and trialing. In addition, given that reward sensitivity was also predictive, a scheme which rewards novice drivers for safe driving behaviour - rather than rewarding the novice through emotional and instrumental rewards for risky driving behaviour - requires further investigation. The Police were also influential in the risky driving behaviour of young novices. Young novice drivers who had been detected for an offence, and then avoided punishment, reacted differentially, with some drivers appearing to become less risky after the encounter, whilst for others their risky behaviour appeared to be reinforced and therefore was more likely to be performed again. Such drivers saw t

Do cyberbullies suffer too? Cyberbullies' perceptions of the harm they cause to others and to their own mental health

While it is recognised that there are serious correlates for students who are victims of cyberbullying including depression, anxiety, lower self-esteem and social difficulties, there has been little research attention paid to the mental health of students who cyberbully. It is known that students who traditionally bully report they feel indifferent to their victims, showing a lack of empathy and that they themselves are at increased risk for psychosocial adjustment. However, there is scant research on the mental health associations of students who cyberbully or their awareness of their impact on others. The current study sought to ascertain from Australian students who reported cyberbullying others in years 6 to 12 (10-19 years of age), their perceptions of their mental health and the harm they caused to and the impact their actions had, on their victims. Most students who cyberbullied did not think that their bullying was harsh or had an impact on their victims. They reported more social difficulties and higher scores on stress, depression and anxiety scales than those students who were not involved in any bullying. The implications of these findings for the mental health of the cyberbullies and for psychologists in schools who assist them, are dis-cussed.

Characteristics of Chinese drivers attending a mandatory training course following license suspension

Penalties and sanctions to deter risky/illegal behaviours are important components of traffic law enforcement. Sanctions can be applied to the vehicle (e.g., impoundment), the person (e.g., remedial programs or jail), or the licence (e.g., disqualification). For licence sanctions, some offences attract automatic suspension while others attract demerit points which can indirectly lead to licence loss. In China, a licence is suspended when a driver accrues twelve demerit points within one year. When this occurs, the person must undertake a one-week retraining course at their own expense and successfully pass an examination to become relicensed. Little is known about the effectiveness of this program. A pilot study was conducted in Zhejiang Province to examine basic information about participants of a retraining course. The aim was to gather baseline data for future comparison. Participants were recruited at a driver retraining centre in a large city in Zhejiang Province. In total, 239 suspended drivers completed an anonymous questionnaire which included demographic information, driving history, and crash involvement. Overall, 87% were male with an overall mean age of 35.02 years (SD=8.77; range 21-60 years). A large proportion (83.3%) of participants owned a vehicle. Commuting to work was reported by 64% as their main reason for driving, while 16.3% reported driving for work. Only 6.4% reported holding a licence for 1 year or less (M=8.14 years, SD=6.5, range 1-31 years) and people reported driving an average of 18.06 hours/week (SD=14.4, range 1-86 hours). This represents a relatively experienced group, especially given the increase in new drivers in China. The number of infringements reportedly received in the previous year ranged from 2 to 18 (M=4.6, SD=3.18); one third of participants reported having received 5 or more infringements. Approximately one third also reported having received infringements in the previous year but not paid them. Various strategies for avoiding penalties were reported. The most commonly reported traffic violations were: drink driving (DUI; 0.02-0.08 mg/100ml) with 61.5% reporting 1 such violation; and speeding (47.7% reported 1-10 violations). Only 2.2% of participants reported the more serious drunk driving violation (DWI; above 0.08mg/100ml). Other violations included disobeying traffic rules, using inappropriate licence, and licence plate destroyed/not displayed. Two-thirds of participants reported no crash involvement in the previous year while 14.2% reported involvement in 2-5 crashes. The relationship between infringements and crashes was limited, however there was a small, positive significant correlation between crashes and speeding infringements (r=.2, p=.004). Overall, these results indicate the need for improved compliance with the law among this sample of traffic offenders. For example, lower level drink driving (DUI) and speeding were the most commonly reported violations with some drivers having committed a large number in the previous year. It is encouraging that the more serious offence of drunk driving (DWI) was rarely reported. The effectiveness of this driver retraining program and the demerit point penalty system in China is currently unclear. Future research including driver follow up via longitudinal study is recommended to determine program effectiveness to enhance road safety in China.

Hepatitis C : a socio-cultural perspective on the effects of a new virus on a community’s health

Since the emergence of diagnostic medical tests in Australia in 1990, hepatitis C (HCV) has been shown to account for over 90 percent of all non-A non-B hepatitis, revealing it to be a widespread and major public health problem. The diagnosis of HCV involves a diverse range of issues for affected persons, introducing identity and lifestyle changes, which are commonly articulated through psychological concepts. In this article we argue that it is important to examine the broader social and cultural contexts that contribute to the experiences of persons affected by HCV. The thematic analysis of qualitative data from six individuals diagnosed with HCV is included to exemplify some of the processes that are involved in the changing identity of a person following a positive diagnosis. The theoretical framework for the interpretation of these processes is interpretive interactionism. In this research, we are attempting to extend the understanding of the effects of HCV diagnoses beyond internal, psychological processes by examining how these diagnoses transform some of the processes of self-formation and expression. The participants’ experiences indicate that there are at least four dimensions of self that were significant to their changing sense of self: relationship of self to others; the emotional self; self-stories and identity; and self-scrutiny and relationships. We conclude that a socio-cultural perspective contributes to the explanation of the transition period following a HCV-positive diagnosis and the redefinition of self towards a HCV status.