Bariatric patients and the use of mobile hoists : user experiences from three hospitals in South Australia

Nursing personnel are consistently identified as one of the occupational groups most at risk of work-related musculoskeletal disorders. During the moving and handling of bariatric patients, the weight of the patient combined with atypical body mass contributes to a significant risk of injury to the care provider and patient. This is further compounded by the shape, mobility and co-operation of the patient. The aim of this study was determine user experiences and design requirements for mobile hoists with bariatric patients. Structured interviews were conducted with six experienced injury management staff from the Manual Task Services department of three hospitals in Adelaide, South Australia. All staff had experience in patient handling, the use of patient handling equipment and the provision of patient handling training. A series of open-ended questions were structured around five main themes: 1) patient factors; 2) building/vehicle space and design; 3) equipment and furniture; 4) communication; and 5) staff issues. Questions focussed on the use of mobile hoists for lifting and transferring bariatric patients. Interviews were supplemented with a walk-through of the hospital to view the types of mobile hoists used, and the location and storage of equipment. Across the three hospitals there were differing classification systems to define bariatric patients. Ensuring patient dignity, respect and privacy were viewed as important in the management and rehabilitation of bariatric patients. Storage and space constraints were considered factors restricting the use of mobile floor hoists, with ceiling hoists being the preferred method for patient transfers. When using mobile floor hoists, the forces required to push, pull and manoeuvre, as well as sudden unstable movements of the hoist were considered important risks factors giving rise to a risk of injury to the care provider. Record keeping and purchasing policies appeared to inhibit the effective use of patient handling equipment. The moving and handling of bariatric patients presents complex and challenging issues. A co-ordinated and collaborative approach for moving and handling bariatric patients is needed across the range of care providers. Designers must consider both user and patient requirements.

Measuring urban form : a comparative analysis of South East Queensland and South Florida

At first glance the built environments of South Florida and South East Queensland appear very similar, particularly along the highly urbanized coast. However this apparent similarity belies some fundamental differences between the two regions in terms of context and the approach to regulating development. This paper describes some of these key differences, but focuses on two research questions: 1) do these differences affect the built environment; and 2) if so, how does the built form differ? There has been considerable research on how to best measure urban form, particularly as it relates to measuring urban sprawl (Schwarz 2010; Clifton et al. 2008). Some of the key questions identified by this research include: what are the best variables to use?; what scale should be used?; and what time period to use? We will assimilate this research in order to develop a methodology for measuring urban form and apply it to both case study regions. There are several potential outcomes from this research -- one is that the built form between the two regions is quite different; and the second is that it is similar. The first outcome is what might be expected given the differences in context and development regulation. However how might the second outcome be explained – major differences in context and development regulation resulting in minor differences in key measures of urban form? One explanation is that differences in the way development is regulated are not as important in determining the built form as are private market forces.

Do planning regulations matter? : a comparison of South East Queensland and South Florida

At one level the urban landscapes of South Florida and South East Queensland look quite similar. However at another level the context of planning and planning control and regulation is quite different. To understand the contextual differences between South Florida and South East Queensland, four themes will be used, some of which were based on Cullingworth and Booth. The four themes include: demography, governance, the law and regulatory philosophy. After having evaluated South Florida and South East Queensland across these four themes, we propose a framework for examining whether these differences have shaped planning outcomes and in particular, the built form.

Sex work and health in a rural context: results of qualitative study undertaken in New South Wales

The paper reports health related findings of the first study undertaken of rural sex workers in an income-rich nation. In-depth interviews were conducted with eighteen purposively selected women who work in the rural sex industry. Rural sex services have a unique structure which informs the experiences of sex workers. Recent advances in telecommunications technology have impacted upon the organisation and structure of the sex industry in rural environments. Notable has been the growth of escort services in rural areas, which has diversified the rural sex industry from its traditional base of brothel operations. The general absence of street prostitution in rural settings has meant that the profile of rural sex workers tends to resemble that of escorts or call girls in urban settings, with workers having a relatively high level of control over working conditions and compliance with public health initiatives. Important issues which impact upon the rural sex industry include confidentiality and the more limited market for sexual services likely to be encountered in rural settings. These issues may impact on the sexual health of rural sex workers in terms of risk practices and access to health services.

Epidemiology and risk factors of oral cancer in South Africa

Head and neck cancers are some of the leading cancers in the coloured and black South African male population and the perception exists that the incidence rates are rising. Aims: To determine the standardised morbidity rates and some of the risk factors for oral cancer in South Africa. Methods: Using histologically verified data from the National Cancer Registry, the age standardised incidence rates (ASIR) and life-time risks (LR) of oral cancer in South Africa were calculated for 1988-1991.2. In an ongoing case control study (1995 +) among black patients in Johannesburg/Soweto, adjusted odds ratios for developing oral cancers in relation to tobacco and alcohol consumption were calculated. Results: Coloured males vs. females: ASIR 13.13 vs. 3.5 (/100,000/year), LR 1:65 vs. 1:244. Black males vs. females: ASIR 9.06 vs. 1.75, LR 1:86 and 1:455. White males vs. females: ASIR 8.06 vs. 3.18, LR 1:104 vs. 1:278. Asian males vs. females: ASIR 5.24 vs. 6.66, LR 1:161 vs. 1:125. The odds ratio for oral cancer in black males in relation to smoking was 7.0 (95% CI 3.0-14.6) and daily alcohol consumption 1.3 (95% CI 0.6-2.8). In black females the odds ratios in relation to smoking were 3.9 (95% CI 1.7 8.9) and daily alcohol consumption 1.7(95% CI 0.7-4.1). Conclusions: The risk factors for oral cancer in South Africa are multiple and gender discrepancies in ASIR and LR signal differences in exposure to carcinogens. It is unclear whether the incidence of oral cancers will rise in the future.

Inconsistency of surrogate measures of alcohol-related accidents in South Australia

Three major changes in drink driving enforcement have occurred in South Australia since 1981. The effect of these changes on a number of surrogate measures of alcohol involvement in accidents were investigated. The surrogates included alcohol involvement of driver fatalities, and combinations of casualty, serious casualty, single vehicle and nighttime accidents. Data from previous studies were also cited. It was found that relationships between surrogate measures were inconsistent, and incompatible with assumptions about drink driving levels and related accidents. It was concluded that until these effects are understood the use of surrogate measures should be treated with caution.

Moving from Awareness to Knowing, Understanding, Speaking and Doing: Indigenous Women Academics in Higher Education. National Tertiary Education Women's Conference, 18-19 July 2009, South Melbourne, Victoria.

Bronwyn Fredericks was asked to outline some of the issues faced by Indigenous women academics.