Television viewing habits associated with obesity risk factors: a survey of Melbourne schoolchildren.

Objectives: To examine whether children’s television viewing may be a useful indicator of risk of obesity-promoting versus healthy eating behaviours, low-level physical activity (PA) and overweight or obesity among children of primary school entry and exit ages. Design: Cross-sectional study, stratified by area-level socioeconomic status. Participants and setting: 1560 children (613 aged 5–6 years [50% boys], and 947 aged 10–12 years [46% boys]) from 24 primary schools in Melbourne, Australia, randomly selected proportionate to school size between 1 November 2002 and 30 December 2003 . Main outcome measures: Parents’ reports of the time their child spends watching television, their participation in organised physical activities (PA), and their food intake; each child’s measured height and weight and their PA levels as assessed by accelerometry for one week. Results: After adjusting for the age and sex of child, the parents’ level of education, clustering by school, and all other health behaviour variables, children who watched television for > 2 h/day were significantly more likely than children who watched television for ≤ 2 h/day to: to have one or more serves/day of high energy drinks (adjusted odds ratio [AOR], 2.31; 95% CI, 1.61–3.32), and to have one or more serves/day of savoury snacks (AOR, 1.50; 95% CI, 1.04–2.17). They were also less likely to have two or more serves/day of fruit (AOR, 0.58; 95% CI, 0.46–0.74), or to participate in any organised PA (AOR, 0.52; 95% CI, 0.34–0.80). Conclusions: Health practitioners in the primary care setting may find that asking whether a child watches television for more than 2 hours daily can be a useful indicator of a child’s risk of poor diet and low physical activity level.

Is more better? The relationship between outcomes achieved by problem gamblers and the number of counselling sessions attended

This paper addresses the question of how much intervention is necessary for the effective treatment of problem gambling by exploring the relationship between the number of counselling sessions attended and the degree of problem resolution achieved for 613 individuals who attended problem gambling counselling services in Victoria. While those who achieved partial or full resolution of presenting problems attended more sessions than those who finished counselling with their problems still unresolved, problems were typically reported as being resolved in fewer than five sessions. It is concluded that for some problem gamblers a relatively brief intervention may be sufficient.

Building Nature’s Safety Net 2014 : A decade of protected area achievements in Australia

The single most important asset for the conservation of Australia’s unique and globally significant biodiversity is the National Reserve System, a mosaic of over 10,000 discrete protected areas on land on all tenures: government, Indigenous and private,including on-farm covenants, as well as state, territory and Commonwealth marine parks and reserves.THE NATIONAL RESERVE SYSTEMIn this report, we cover major National Reserve System initiatives that have occurred in the period 2002 to the present and highlight issues affecting progress toward agreed national objectives. We define a minimum standard for the National Reserve System to comprehensively, adequately and representatively protect Australia’s ecosystem and species diversity on sea and land. Using government protected area, species and other relevant spatial data, we quantify gaps: those areas needing to move from the current National Reserve System to one which meets this standard. We also provide new estimates of financial investments in protected areas and of the benefits that protected areas secure for society. Protected areas primarily serve to secure Australia’s native plants and animals against extinction, and to promote their recovery.BENEFITSProtected areas also secure ecosystem services that provide economic benefits forhuman communities including water, soil and beneficial species conservation, climatemoderation, social, cultural and health benefits. On land, we estimate these benefitsare worth over $38 billion a year, by applying data collated by the Ecosystem ServicesPartnership. A much larger figure is estimated to have been secured by marineprotected areas in the form of moderation of climate and impact of extreme eventsby reef and mangrove ecosystems. While these estimates have not been verified bystudies specific to Australia, they are indicative of a very large economic contributionof protected areas. Visitors to national parks and nature reserves spend over $23.6 billion a year in Australia, generating tax revenue for state and territory governments of $2.36 billion a year. All these economic benefits taken together greatly exceed the aggregate annual protected area expansion and management spending by all Australian governments, estimated to be ~$1.28 billion a year. It is clear that Australian society is benefiting far greater than its governments’ investment into strategic growth and maintenance of the National Reserve System.Government investment and policy settings play a leading role in strategic growth of the National Reserve System in Australia, and provide a critical stimulus fornon-government investment. Unprecedented expansion of the National Reserve System followed an historic boost in Australian Government funding under Caring for Our Country 2008–2013. This expansion was highly economical for the Australian Government, costing an average of only $44.40 per hectare to buy and protect land forever. State governments have contributed about six times this amount toward the expansion of the National Reserve System, after including in-perpetuity protected area management costs. The growth of Indigenous Protected Areas by the Australian Government has cost ~$26 per hectare on average, including management costs capitalised in-perpetuity, while also delivering Indigenous social and economic outcomes. The aggregate annual investment by all Australian governments has been ~$72.6 million per year on protected area growth and ~$1.21 billion per year on recurrent management costs. For the first time in almost two decades, however, the Australian Government’s National Reserve System Program, comprising a specialist administrative unit and funding allocation, was terminated in late 2012. This program was fundamental in driving significant strategic growth in Australia’s protected area estate. It is highly unlikely that Australia can achieve its long-standing commitments to an ecologically representative National Reserve System, and prevent major biodiversity loss, without this dedicated funding pool. The Australian Government has budgeted ~$400 million per year over the next five years (2013-2018) under the National Landcare and related programs. This funding program should give high priority to delivery of national protected area commitments by providing a distinct National Reserve System funding allocation. Under the Convention on Biological Diversity (CBD), Australia has committed to bringing at least 17 percent of terrestrial and at least 10 per cent of marine areas into ecologically representative, well-connected systems of protected areas by 2020 (Aichi Target 11).BIODIVERSITY CONSERVATIONAustralia also has an agreed intergovernmental Strategy for developing a comprehensive, adequate and representative National Reserve System on land andsea that, if implemented, would deliver on this CBD target. Due to dramatic recent growth, the National Reserve System covers 16.5 per cent of Australia’s land area, with highly protected areas, such as national parks, covering 8.3 per cent. The marine National Reserve System extends over one-third of Australian waters with highly protected areas such as marine national parks, no-take or green zones covering 13.5 per cent. Growth has been uneven however, and the National Reserve System is still far from meeting Aichi Target 11, which requires that it also be ecologically representative and well-connected. On land, 1,655 of 5,815 ecosystems and habitats for 138 of 1,613 threatened species remain unprotected. Nonetheless, 436 terrestrial ecosystems and 176 threatened terrestrial species attained minimum standards of protection due to growth of the National Reserve System on land between 2002 and 2012. The gap for ecosystem protection on land – the area needed to bring all ecosystems to the minimum standard of protection – closed by a very substantial 20 million hectares (from 77 down to 57 million hectares) between 2002 and 2012, not including threatened species protection gaps. Threatened species attaining a minimum standard for habitat protection increased from 27 per cent to 38 per cent over the decade 2002–2012. A low proportion of critically endangered species meeting the standard (29 per cent) and the high proportion with no protection at all (20 per cent) are cause for concern, but one which should be relatively easy to amend, as the distributions of these species tend to be small and localised. Protected area connectivity has increased modestly for terrestrial protected areas in terms of the median distance between neighbouring protected areas, but this progress has been undermined by increasing land use intensity in landscapes between protected areas.A comprehensive, adequate and representative marine reserve system, which meetsa standard of 15 per cent of each of 2,420 marine ecosystems and 30 per cent of thehabitats of each of 177 marine species of national environmental significance, wouldrequire expansion of marine national parks, no-take or green zones up to nearly 30per cent of state and Australian waters, not substantially different in overall extentfrom that of the current marine reserve system, but different in configuration.Protection of climate change refugia, connectivity and special places for biodiversityis still low and requires high priority attention. FINANCING TO FILL GAPS AND MEET COMMITMENTSIf the ‘comprehensiveness’ and ‘representativeness’ targets in the agreed terrestrial National Reserve System Strategy were met by 2020, Australia would be likely to have met the ‘ecologically representative’ requirement of Aichi Target 11. This would requireexpanding the terrestrial reserve system by at least 25 million hectares. Considering that the terrestrial ecosystem protection gap has closed by 20 million hectares over the past decade, this required expansion would be feasible with a major boost in investment and focus on long-standing priorities. A realistic mix of purchases, Indigenous Protected Areas and private land covenants would require an Australian Government National Reserve System investment of ~$170 million per year over the five years to 2020, representing ~42 per cent of the $400 million per year which the Australian Government has budgeted for landcare and conservation over the next five years. State, territory and local governments, private and Indigenous partners wouldlikewise need to boost financial commitments to both expand and maintain newprotected areas to meet the agreed National Reserve System strategic objectives.The total cost of Australia achieving a comprehensive, adequate and representativemarine reserve system that would satisfy Aichi Target 11 is an estimated $247 million.

6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial

OBJECTIVE:  To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. DESIGN:  Cluster randomised controlled trial. SETTING:  Six Australian hospitals. PARTICIPANTS:  All patients admitted to 24 acute wards during the trial period. INTERVENTIONS:  Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: "falls alert" sign, supervision of patients in the bathroom, ensuring patients' walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. MAIN OUTCOME MEASURES:  The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. RESULTS:  During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients' characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; P<0.001). In all, 1831 falls and 613 fall injuries occurred, and the rates of falls (incidence rate ratio 1.04, 0.78 to 1.37; P=0.796) and fall injuries (0.96, 0.72 to 1.27; P=0.766) were similar in intervention and control wards. CONCLUSIONS:  Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. TRIAL REGISTRATION:  Australian New Zealand Clinical Trials Registry ACTRN12611000332921.