Investigation of the benefits of HIV/AIDS caregiving and relations among caregiving adjustment, benefit finding, and stress and coping variables

The present study explored the nature of benefit finding in HIV/AIDS caregiving, and examined relations among caregiver adjustment, benefit finding, and stress and coping variables. A total of 64 HIV/AIDS caregivers and 46 care recipients completed interviews and questionnaires. First, the study aimed to explore the types of benefits associated with HIV/AIDS caregiving. Content analyses of caregiver responses to an interview question inquiring about gains from caregiving revealed eight benefit themes. Second, the study aimed to examine relations between caregiver adjustment and both benefit finding and stress and coping variables. We hypothesized that number of caregiver reported benefits, social support, challenge and control appraisals, and problem focused coping would be inversely related to poorer adjustment, whereas care recipient reported global distress and illness, caregiver threat appraisal and passive-avoidant emotion-focused coping would be positively associated with poorer adjustment. Correlations indicated that poorer adjustment (measured by global distress, depression, caregiving impact, social adjustment and health status) was positively correlated with care-recipient distress, threat appraisals and passive avoidant coping and inversely correlated with social support, and number of reported benefits. Unexpectedly, problem-focused coping, controllability and challenge appraisals, and care recipient illness were unrelated to adjustment. Third, the study aimed to examine relations between benefit finding and stress and coping variables. Correlations indicated that benefit finding was related to social support use, seeking social support coping and problem-solving coping. Findings indicate that the benefit finding and stress/coping frameworks have utility in guiding research into adaptation to HIV/AIDS caregiving. Results also indicate targets for intervention in the provision of services for HIV/AIDS caregivers.

The effect of skin examination surveys on the incidence of basal cell carcinoma in a Queensland community sample: A 10-year longitudinal study

Skin cancers pose a significant public health problem in high-risk populations. We have prospectively monitored basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) incidence in a Queensland community over a 10-y period by recording newly treated lesions, supplemented by skin examination surveys. Age-standardized incidence rates of people with new histologically confirmed BCC were 2787 per 100,000 person-years at risk (pyar) among men and 1567 per 100,000 pyar among women, and corresponding tumor rates were 5821 per 100,000 pyar and 2733 per 100,000 pyar, respectively. Incidence rates for men with new SCC were 944 per 100,000 pyar and for women 675 per 100,000 pyar; tumor rates were 1754 per 100,000 pyar and 846 per 100,000 pyar, respectively. Incidence rates of BCC tumors but not SCC tumors varied noticeably according to method of surveillance, with BCC incidence rates based on skin examination surveys around three times higher than background treatment rates. This was mostly due to an increase in diagnosis of new BCC on sites other than the head and neck, arms, and hands associated with skin examination surveys and little to do with advancing the time of diagnosis of BCC on these sites as seen by a return to background rates following the examination surveys. We conclude that BCC that might otherwise go unreported are detected during skin examination surveys and thus that such skin cancer screening can influence the apparent burden of skin cancer.

Participants who left a multiple-wave cohort study had similar baseline characteristics to participants who returned

PURPOSE: Research on determinants of an individual's pattern of response, considered as a profile across time, for cohort studies with multiple waves is limited. In this prospective population-based pregnancy cohort, we investigated baseline characteristics of participants after partitioning them according to their history of response to different interview waves. METHODS: Data are from the Mater-University of Queensland Study of Pregnancy 1981 to 1983 cohort, Brisbane, Australia. Complete baseline information was collected for 7223 of 7535 eligible individuals (95.9%). Follow-up occurred at 6 months, 5 years, and 14 years. Response rates were 93.0%, 72.5%, and 71.8%. Participants were allowed to leave and reenter the study. Participants were categorized as always, intermittent, or never responders. Intermittent responders were categorized further as leavers (responded at least once before leaving the study) or returners (left the study before reentering). RESULTS: Participants who always responded were older, more educated, married, Caucasian, and nonsmokers and had higher incomes. Intermittent responders shared similar baseline characteristics. Relative risk for being an intermittent responder was located between risks for always or never responding. CONCLUSIONS: Participants who left and reentered the study had baseline characteristics similar to participants who responded at least once and then left the study.

Early intervention for children and their parents following paediatric accidental injury

This study was undertaken to develop and evaluate the efficacy of an early intervention for children who had been injured in an accident. The aim of the intervention was to prevent the development of longterm psychological consequences. Brochures were developed for children, adolescents, and their parents. These brochures detailed common responses to trauma (and normalized such responses), and suggestions for minimizing any post-trauma distress. Participants were children aged 7-15 admitted to hospital for traumatic injury. The intervention was delivered to one of two hospitals, within 72 hours of the trauma. 103 children and parents participated in the study. The parents and children completed structured interviews and questionnaires 2 weeks, 4-6 weeks and 6 months post-trauma. Outcome analyses also indicated that the intervention reduced parental distress at 4-6 weeks post-trauma. The intervention did not impact significantly on child adjustment over this time period. Results of the 6 month follow-up suggested that the intervention resulted in an amelioration of child anxiety from one to six months post-trauma, whereas the controls exhibited an increase in anxiety over this time period. Overall, it was concluded that the early intervention is a simple, practical, and cost-effective method of reducing child and parent distress post-trauma.

The paradox of managerial downsizing

Delayering and the flattening of organizational hierarchies was a widespread trend through the 1990s. Peters (1992) in the USA promoted flattening as an organizational strategy and Keuning and Opheij (1994) promoted the prescriptions in Europe. Despite these strategies and apparent structural changes, the number and ratio of managers appears to have grown. This paradox of managerial downsizing has not been adequately probed in the literature. The predominant explanation, that there has been a 'myth of managerial downsizing', is associated with Gordon (1996). However, this debate has been shaped by the US experience and data. There is a need to reassess the dynamics of the 1990s in relation to other economies. This article focuses on a semi-peripheral economy, that of Australia. A study of the population of firms over time is necessary in order to resolve the issues. The article utilizes a comprehensive range of data, including several national surveys and a longitudinal database of all larger private-sector firms in Australia during the 1990s. The results indicate that the 'myth of managerial downsizing' must be rejected. There were dramatic effects on managers through the course of the 1990s in larger Australian firms. The dynamics of the process are analysed, tracking 4,153 firms across the decade and the paradox explained. The theoretical implications are discussed.

Protective Eyewear Promotion: Applying Principles of Behaviour Change in the Design of a Squash Injury Prevention Programme

Eye injuries in squash have the potential to be severe. Although these injuries can be prevented through the use of protective eyewear, few players wear such eyewear. The aim of this paper is, to outline the behavioural principles guiding the design of a squash eyewear promotion initiative, the Protective Eyewear Promotion (PEP). Ecological principles of behaviour change were used to provide a comprehensive perspective on intrapersonal factors, policies and physical environmental influences of protective eyewear use. Results of baseline player surveys and venue manager inter-views were used to provide relevant and specific intervention content. At baseline, protective eyewear was not found to be readily available, and players' behaviours, knowledge and attitudes did not favour its use. The main components of PEP involved informing and educating both players and squash venue operators of the risk of eye injury and of appropriate protective eyewear, as well as assisting with the availability of the eyewear and offering incentives for players to use it. A structural strength of PEP was the strong collaborative links with the researchers of different disciplines, the squash governing body, eyewear manufacturers, squash venue personnel, as well as players. Attempts were made within the project structure to make provision for the future dissemination and sustainability of more widespread eye injury prevention measures in the sport of squash.

Monitoring green turtles (Chelonia mydas) at a coastal foraging area in Baja California, Mexico: multiple indices to describe population status

From June 1995 to August 2002 we assessed green turtle (Chelonia mydas) population structure and survival, and identified human impact, at Bahia de los Angeles, a large bay that was once the site of the greatest sea turtle harvest rates in the Gulf of California, Mexico. Turtles were captured live with entanglement nets and mortality was quantified through stranding surveys and flipper tag recoveries. A total of 14,820 netting hours (617.5 d) resulted in 255 captures of 200 green turtles. Straight-carapace length and mass ranged from 46.0-100.0 cm (mean = 74.3 +/- 0.7 cm) and 14.5-145.0 kg (mean = 61.5 +/- 1.7 kg), respectively. The size-frequency distribution remained stable during all years and among all capture locations. Anthropogenic-derived injuries ranging from missing flippers to boat propeller scars were present in 4% of captured turtles. Remains of 18 turtles were found at dumpsites, nine stranded turtles were encountered in the study area, and flipper tags from seven turtles were recovered. Survival was estimated at 0.58 for juveniles and 0.97 for adults using a joint live-recapture and dead-recovery model (Burnham model). Low survival among juveniles, declining annual catch per unit effort, and the presence of butchered carcasses indicated human activities continue to impact green turtles at this foraging area.

Residents' perceptions of walkability attributes in objectively different neighbourhoods: a pilot study

Physical attributes of local environments may influence walking. We used a modified version of the Neighbourhood Environment Walkability Scale to compare residents' perceptions of the attributes of two neighbourhoods that differed on measures derived from Geographic Information System databases. Residents of the high-walkable neighbourhood rated relevant attributes of residential density, land-use mix (access and diversity) and street connectivity, consistently higher than did residents of the low-walkable neighbourhood. Traffic safety and safety from crime attributes did not differ. Perceived neighbourhood environment characteristics had moderate to high test retest reliabilities. Neighbourhood environment attribute ratings may be used in population surveys and other studies. (c) 2004 Elsevier Ltd. All rights reserved.

Recent developments on a nearshore, terrigenous-influenced reef: Low Isles Reef, Australia

Low Isles Reef is the most southerly located of 46 coral reef platforms unique to the inner shelf of the northern Great Barrier Reef Province, Australia, which support both sea grass and mangrove growth. Such reefs develop in areas that are influenced by river flood plumes and where interreef sediments are dominated by terrigenous mud. Low Isles Reef has long been a popular tourist destination. Informal reports of decreasing visibility, a decline in scleractinian corals, and increases in soft coral and macroalgae have sparked speculation that agricultural activities in coastal catchments are affecting the reef. Comparison of the modern surface of Low Isles Reef with historical surveys and photographs dating back to 1928 allows quantification of modern sedimentary processes, rates of change, and factors influencing reef development. Results indicate that changes on Low Isles Reef are related to remobilization of coarse sediment during storm events and gradual shoreline retreat associated with rising sea level. Retreat of shingle ramparts and elongate ridges of coral debris toward the reef interior has led to the infilling of subtidal ponds on the reef top, which supported hard coral colonies in 1928. The gradual development of a composite shingle rampart along the windward margin has promoted an increase (;150%) in the area of the reef top covered by mangroves. On the leeward margin, a decrease in hard corals since 1950 may reflect a rising contribution of organic debris from the expanding mangrove swamp. Results suggest that recent changes on Low Isles Reef can be explained in the context of natural processes. Further study is needed before the effects of agricultural activities in coastal catchments on reef health can be confirmed.

Contribution of changes in risk factors to the decline of coronary heart disease mortality in Australia over three decades

BACKGROUND: Coronary heart disease has been a major cause of mortality in Australian adults, but the rate has declined by 83% from the 1968 peak by the year 2000. The study objective is to determine the contribution of changes in population risk factors - mean serum cholesterol and diastolic blood pressure and tobacco smoking prevalence - to the decline in coronary heart disease mortality in Australia over three decades. METHODS: Coronary heart disease deaths (International Classification of Disease-9, 410-414) and population by year, age group and sex were obtained from the Australian Bureau of Statistics. Risk factor levels were obtained from population surveys and estimated average annual changes by period were used to calculate average annual 'attributable' proportional declines in CHD mortality by period (age 35-64 years). RESULTS: Over the period 1968-2000, 74% of male decline and 81% of the female decline in coronary heart disease mortality rate was accounted for by the combined effect of reductions in the three risk factors. In males 36% of the decline was contributed by reductions in diastolic blood pressure, 22% by cholesterol and 16% by smoking. For females 56% was from diastolic blood pressure reduction, 20% from cholesterol and 5% from smoking. Effects of reductions in serum cholesterol on coronary heart disease mortality occurred mainly in the 1970s. Declines in diastolic blood pressure had effects on coronary heart disease mortality over the three decades, and declines in tobacco smoking had a significant effect in males in the 1980s. CONCLUSION: Most of the spectacular decline in coronary heart disease mortality over the last three decades in Australia can be ascribed to reductions in population risk factors from primary and secondary prevention.

Testing alternative models for the conservation of koalas in fragmented rural-urban landscapes

Predicting the various responses of different species to changes in landscape structure is a formidable challenge to landscape ecology. Based on expert knowledge and landscape ecological theory, we develop five competing a priori models for predicting the presence/absence of the Koala (Phascolarctos cinereus) in Noosa Shire, south-east Queensland (Australia). A priori predictions were nested within three levels of ecological organization: in situ (site level) habitat (< 1 ha), patch level (100 ha) and landscape level (100-1000 ha). To test the models, Koala surveys and habitat surveys (n = 245) were conducted across the habitat mosaic. After taking into account tree species preferences, the patch and landscape context, and the neighbourhood effect of adjacent present sites, we applied logistic regression and hierarchical partitioning analyses to rank the alternative models and the explanatory variables. The strongest support was for a multilevel model, with Koala presence best predicted by the proportion of the landscape occupied by high quality habitat, the neighbourhood effect, the mean nearest neighbour distance between forest patches, the density of forest patches and the density of sealed roads. When tested against independent data (n = 105) using a receiver operator characteristic curve, the multilevel model performed moderately well. The study is consistent with recent assertions that habitat loss is the major driver of population decline, however, landscape configuration and roads have an important effect that needs to be incorporated into Koala conservation strategies.