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President’s Report Hello fellow AITPM members, Welcome to the first edition of the AITPM National Newsletter for 2009! I trust we all had a relaxing break and managed to lose track of all things transport for just a little while. I know I had trouble doing so when hunting for a car space at the shopping centre, and experiencing new projects such as the Tugun Bypass – the new gateway between New South Wales and Queensland. Byron Bay is now as close as Noosa for those high profile beach goers of Brisbane. There was also my experience of the reduced posted speed of 90km/h on the Bruce Highway around the troublesome Gympie stretch, when returning from a short Fraser Coast holiday. I expect that this relatively inexpensive safety improvement will pay substantial dividends in terms of crash reduction. The Newsletter took its annual leave last month and is refreshed and ready for a new year to keep us all informed of the latest in traffic and transport engineering, planning and management. I would like to take this opportunity to acknowledge the ongoing significant contributions of many volunteers in the Newsletter’s production. Mr Andrew Hulse, AITPM’s Immediate Past National President, serves as the Editorial Coordinator on behalf of the Institute. Each Branch Committee also includes a Newsletter Coordinator and committee members frequently contribute as well. And the ongoing contributions of readers enable us to offer the Newsletter as a vehicle for dialogue and debate around our sector. If you would like to contribute please email AITPM’s administration officer Josephine Mitton at aitpm@aitpm.com or through your local Branch Committee. I would also like to welcome back on deck our Editor, Mr David Brown of Driven Media, who creates a fantastic package for us each month. Lastly, members would have received the Call for Papers for the AITPM 2009 National Conference, Traffic Beyond Tomorrow, to be held at the Adelaide Convention Centre between 5 – 7 August. Abstracts will be accepted up to 20 February 2009. We look forward to seeing everyone at this, our flagship event for the year. To all a good year ahead, Jon Bunker Post Script: We all will have seen through the media the enormous scale and nature of the two natural disasters Australia is experiencing at present. AITPM’s thoughts are with all of those members, family and friends who may be experiencing hardship as a result of the Victorian bushfires and North Queensland floods. AITPM is a not for profit organisation however the National Executive has taken the decision to donate in measure to the Red Cross Victorian Bushfire Disaster Relief fund and the Queensland Premier’s Disaster Relief fund as a gesture to support our fellow Australians in their time of need. Details about these funds can be found via the Victorian and Queensland Governments’ websites.
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President’s Report Hello fellow AITPM members, First I would like on behalf of all AITPM members to send our condolences to all who have been affected by February’s tragic bushfires in regional Victoria, and deliver our best wishes to all of those involved in the rebuilding efforts. Over time I expect that the Victorian Government’s Royal Commission will analyse the circumstances and put forward a range of measures which will improve fire safety in vulnerable areas. As transport professionals it will be important for us to consider the findings and look to undertaking any recommendations that relate to the work we do. Not only in Victoria, but nationwide. In particular, the importance of logistics was highlighted following the fire events. Donors across Australia were this time requested to donate money rather than goods, presumably due in part to problems associated with the transport system coping with additional uncoordinated freight load, whilst being needed to support emergency management vehicle and managed freight movements. Notwithstanding, it was wonderful to see otherwise difficult to obtain goods, such as animal feed, being donated from far afield and transported in kind by trucking operators. As stated in last month’s Newsletter, AITPM made a direct cash donation to the Red Cross Bushfire Appeal immediately following the events, and a further donation to the Queensland Premier’s Disaster Relief Fund to support recovery after the North Queensland floods, which claimed seven lives. Again, we will need to monitor how the rebuilding effort unfolds particularly in regional Victoria and centres including Ingham in North Queensland, but I would urge all AITPM members who are in a position to support the restoration of the affected communities to play a part, particularly over time once the initial shock subsides and the steady job of rebuilding is underway. Onto lighter matters, AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, being held in Adelaide from 5 to 7 August, is fast approaching. www.aitpm.com has all of the details about how to register, sponsor a booth, and so forth. We are looking forward to catching up with our conference “regulars” and meeting with new folks to AITPM, and Australian traffic and transport planning and management. Adelaide is one of my favourite places to visit and I’m looking forward to riding the light rail line extension through town and checking out progress on the road system development. Best regards all, Jon Bunker
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President’s Report Hello fellow AITPM members, A few weeks ago we saw another example of all levels of Government pulling together in real time to try to deal with a major transport incident, this time it was container loads of ammonium nitrate falling off the Pacific Adventurer during Cyclone Hamish and the associated major oil spill due to piercing of its hull off Moreton Bay in southern Queensland. The oil spill was extensive, affecting beaches and estuaries from Moreton Island north to the Sunshine Coast; a coastal stretch of at least 60km. We saw the Queensland Government, Brisbane, Moreton Bay and Sunshine Coast Regional Council crews deployed quickly once the gravity of the situation was realised to clean up toxic oil on beaches and prevent extensive upstream contamination. Environmental agencies public and private were quick to respond to help affected wildlife. The Navy’s HMAS Yarra and another minesweeper were deployed to search for the containers in the coastal area in an effort to have them salvaged before all ammonium nitrate could leach into and harm marine habitat, which would have a substantial impact not only on that environment but also the fishing industry. all of this during the final fortnight before a State election.) While this could be branded as a maritime problem, the road transport and logistics system was crucial to the cleanup. The private vehicular ferries were enlisted to transport plant and equipment from Brisbane to Moreton Island. The plant themselves, such as graders, were drawn from road building and maintenance inventory. Hundreds of Councils’ staff were released from other activities to undertake the cleanup. While it will take some time for us to know the long term impacts of this incident, it seems difficult to fault “grassroots” government crews and their private counterparts, such as Island tourism staff, in the initial cleanup effort. From a traffic planning and management perspective, we should also remember that this sort of incident has happened on road and rail corridors in the past, albeit on lesser scales. It underlines that we do need to continue to protect communities, commercial interests, and the environment through rigorous heavy vehicle management, planning and management of dangerous goods routesincluding rail corridors through urban areas), and carefully considered incident and disaster recovery plans and protocols. I’d like to close in reminding everyone again that AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, is being held in Adelaide from 5 to 7 August. SA Branch President Paul Morris informs me that we have had over 50 paper submissions to date, from which a very balanced and informative programme of sessions has been prepared. www.aitpm.com has all of the details about how to register, sponsor a booth, session, etc. Best regards all, Jon Bunker
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President’s Message Hello fellow AITPM members, We’ve been offered a lot of press lately about the Federal Government’s plan for the multibillion dollar rollout of its high speed broadband network, which at the moment is being rated to a speed of 100Mb/s. This seems fantastic in comparison to the not atypical 250 to 500kb/s that I receive on my metropolitan cable broadband, which incidentally my service provider rates at theoretical speeds of up to 8 Mb/s. I have no doubt that such a scheme will generate significant advantages to business and consumers. However, I also have some reservations. Only a few of years ago I marvelled at my first 256Mb USB stick, which cost my employer about $90. Last month I purchased a 16Gb stick with a free computer carry bag for $80, which on the back of my envelope has given me about 72 times the value of my first USB stick not including the carry bag! I am pretty sure the technology industry will find a way to eventually push a lot more than 100Mb/s down the optic fibre network just as they have done with pushing several Mb/s ADSL2 down antique copper wire. This makes me wonder about the general problem of inbuilt obsolescence of all things high-tech due to rapid advances in the tech industry. As a transport professional I then think to myself that our industry has been moving forward at somewhat of a slower pace. We certainly have had major milestones having significant impacts, such as the move from horse and cart to the self propelled motor vehicle, sealing and formal geometric design of roads, development of motorways, signalisation of intersections, coordination of networks, to simulation modelling for real time adaptive control (perhaps major change has been at a frequency of 30 years or so?). But now with ITS truly penetrating the transport market, largely thanks to the in-car GPS navigator, smart phone, e-toll and e-ticket, I believe that to avoid our own obsolescence we’re going to need to “plan for ITS” rather than just what we seem to have been doing up until now, that is, to get it out there. And we’ll likely need to do it at a faster pace. It will involve understanding how to data mine enormous data sets, better understanding the human/machine interface, keeping pace with automotive technology more closely, resolving the ethical and privacy chestnuts, and in the main actually planning for ITS to make peoples’ lives easier rather than harder. And in amongst this we’ll need to keep pace with the types of technology advances similar to my USB stick example above. All the while we’ll be making a brand new set of friends in the disciplines that will morph into ITS along with us. Hopefully these will all be “good” problems for our profession to have. I should close in reminding everyone again that AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, is being held in Adelaide from 5 to 7 August. www.aitpm.com has all of the details about how to register, sponsor a booth, session, etc. Best regards all, Jon Bunker
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President’s Message Hello fellow AITPM members, Due to three colliding forces of nature I find myself writing this month’s message from home – today, I am still getting over a persistent virus that seemed to set in just after returning from Singapore a couple of weeks ago, which my diabetes won’t let me get away with too easily (no Kermit the Frog swine flu jokes please). Combine this with a very wet day in Brisbane – in fact the wettest for 20 years (how can we complain, except for flash flooding?). And in Queensland today is a state school teachers’ strike, so one half of our brood is over watching TV. Family snapshots aside, the biggest news for our industry of late is the $8.5 billion announced in the Federal Budget for transport infrastructure projects; many “shovel ready”, but some – and fortunate for our profession – desktop ready. This newsletter provides nationwide coverage on the transport infrastructure aspects of the Federal Budget. We’ll need a bit more time to carefully look at the ensuing State Budgets’ announcements. Regarding the federal budget announcements, I am pleased to see serious attention being paid to upgrading the M1 system – I hope to see a motorway standard facility connecting Adelaide to at least Rockhampton in my lifetime. But some other important roads are of course missing out in this particular budget. Various levels of commitment are being made to urban passenger rail – some project significant while others planning significant. Enhancement of suburban rail is important across the capitals and Australia’s medium sized cities such as the Gold Coast and Newcastle. Not much on road safety initiatives jumped out at me, but I believe it is implied in the large road projects and in some of the detail elsewhere. I do believe it’s about time a ‘Vision Zero’ style policy is adopted at the National level, since any death is unacceptable on the road, just as it is in any other workplace. So, overall some good news on building transport infrastructure to keep the economy purring during this recession, and strongly supporting it during future boom times. The other edge to the sword, of course, is that we tax payers will be paying a considerable amount for borrowings for these projects over a long period of time. I close again in reminding everyone again that AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, is being held in Adelaide from 5 to 7 August. www.aitpm.com has all of the details about how to register, sponsor a booth, session, etc. Best regards all, Jon Bunker
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President’s Message AITPM President’s Message, July 2009 Hello fellow AITPM members, It’s now very early July so many Australians are going to experience a range of new, or increases in, fees, charges, and perhaps taxes by State and local governments. For example, Queenslanders are to be hit at the petrol pump, no longer living with the luxury of the State’s previous 8c per litre fuel subsidy, bringing general motorists’ fuel costs into line with the other States. A consolation is that they now don’t have to live with the real or perceived “price gouging” that has appeared in the past to make Queensland prices much closer than 8c to those in other States. Environmental lobbyists argue that this Government’s decision brings public transport costs closer to parity with private transport. However, my sense from sloppy petrol price elasticities is that the State’s motorists will get used to the reversal of what was a reverse tax pretty quickly, an amount which can be less than day-of-the week fluctuation. On the other hand, withholding this State revenue may help in some way the funding of the several major public transport infrastructure projects in progress; not to mention some of the cost of running the Transit Authority’s expanding service commitments. Other policy actions, such as a Federal Government review of taxation on employees’ package vehicles, which might discourage rather than encourage excess kilometres travelled, may have a greater environmental benefit. Of course, a downside is that many vehicles used so are Australian built, and discouraging fleet turnover may damage an industry which faces ever increasing uncertainty, and particularly at the present, is in need of some care and attention. I for one hope to this end that the new 4 cylinder (1.8L petrol or 2L diesel) so called “true Holden” Cruze and Toyota’s pending Camry Hybrid are both roaring successes, and will be taken up in droves as fleet and employee use vehicles. I’m not sure what drive-trains Ford and Holden plan to drop into their next full sized models but even if they’re not Australian sourced, let’s hope they coordinate the requisite performance expected by the “Aussie Battler” with suitable green credentials. I am also encouraged to see that already many Government fleet vehicles are smaller in size, but still fit for purpose. For instance, my local police station uses the Camry based Aurion as a district car. I close again in reminding everyone that AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, is being held in Adelaide from 5 to 7 August. www.aitpm.com has all of the details about how to register, sponsor a booth, session, etc. Best regards all, Jon Bunker
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President’s Message Hello fellow AITPM members, Just a few days to go until the 2009 AITPM National Conference, Traffic Beyond Tomorrow, being held at the Adelaide Convention Centre from 5 to 7 August. We look forward to catching up with all of our familiar faces as well as many new faces at this year’s conference, which the South Australian Branch has been seaming together like a Singer sewing machine. I’m looking forward to meeting you at the conference and I do hope you can join us for the Institute’s National Annual General Meeting during the event. Until then, best regards to all Jon Bunker
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President’s Message Hello fellow AITPM members, A few weeks have now passed since our 2009 AITPM National Conference, Traffic Beyond Tomorrow, which was held at the Adelaide Convention Centre from 5 to 7 August. I personally had a most enjoyable and enriching time at the Conference and felt these same “vibes” all around me. Top marks go to the South Australia organising committee, convened by Andrew Leedham, for their dedication to this our flagship event for the year. I could go on to cite my highlights but there were too many to give due diligence here. I had a number of official functions to perform at the Conference, but one in particular worth mentioning was being interviewed by radio stations 5AA, the main news/talk commercial broadcaster in Adelaide, and 891 ABC Adelaide. All interviewers were focussed on the issue of congestion charging, which is interesting in its emergence as a public conversation piece. My main responses focussed on the importance of providing alternatives for travel to the motorist otherwise being charged by a scheme, if and when decisions were made to implement congestion charging. I found that these opportunities to present AITPM as a professional peak body were very fruitful. The Queensland organising committee is now in full swing organising the 2010 AITPM National Conference, What’s New?, so please keep a lookout for related content. You’ll also find within this edition a transcript of my President’s Report to the 2009 AITPM National Annual General Meeting, which was held during the Adelaide Conference. Best regards to all, Jon Bunker
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President’s Message Hello fellow AITPM members, Well I can’t believe it’s already October! My office is already organising its end of year function and looking to plan for 2010. Our whole School is moving to a different building next year, with the lovely L block eventually making way for a new shiny one. Those of you who have entered the Brisbane CBD from the south side, across the Captain Cook Bridge, would know L block as the big 9 storey brick and concrete Lego block ode to 1970’s functional architecture, which greets you on the right hand side. Onto traffic matters: an issue that has been tossing around in my mind of late is that of speed. I know I am growing older and may be prematurely becoming a “grumpy old man”, but everyone around me locally seems to be accelerating off from the stop line much faster than I was taught to for economical driving, both here and in the United States (yes they made my wife and me resit our written and practical driving tests when we lived there). People here in Australia also seem to be driving right on top of the posted speed limit, on whichever part of the Road Hierarchy, whether urban or rural. I was also taught on both sides of the planet that the posted speed limit is a maximum legal speed, not the recommended driving speed. This message did seem to sink in to the American drivers around me when we lived in Oregon - where people did appear to drive more cautiously. Further, posted speed limits in Oregon were, and I presume still are, set more conservative by about 5mph or 10km/h than Australian limits, for any given part of the Road Hierarchy. Another excellent speed limit treatment used in Oregon was in school zones, where reduced speed limits applied “when children are present” rather than during prescribed hours on school days. This would be especially useful here in Australia, where a lot of extra-curricular activities take place around schools outside of the prescribed speed limit hours. Before and after hours school care is on the increase (with parents dropping and collecting children near dawn and dusk in the winter), and many childcentred land uses are located adjacent to schools, such as Scouts/Guides halls, swimming pools and parks. Consequentially, I believe there needs to be some consideration towards more public campaigning about economical driving and the real purpose of the speed limit = or perhaps even a rethink of the speed limit concept, if people really are driving on top of it and it’s not just me becoming grumpier (our industrial psychology friends at the research centres may be able to assist us here). The Queensland organising committee is now in full swing organising the 2010 AITPM National Conference, What’s New?, so please keep a lookout for related content. Best regards to all, Jon Bunker PS A Cartoonists view of traffic engineers I thought you might enjoy this. http://xkcd.com/277/
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President’s Report Hello fellow AITPM members, It is interesting to follow the news at present, where transport costs are getting a significant airing. Treasury Secretary Dr Ken Henry has enunciated something Australians may have considered extremely radical just a few years back, but in the present time appears to quite a few to be a realistic alternative. That being a rethink of the way we are charged for using our vehicles. It appears that serious consideration is being given to congestion charging, perhaps in place at least to some extent, of fuel excise. As a transport professional I am pleased that the debate has elevated to the national level, and would look forward that AITPM might contribute appropriately to it. As a motorist though, I naturally have my concerns about being hit in the hip pocket. Not that I actually drive during congested periods very much. I am fortunate to live five minutes either side of two well serviced bus corridors, one of which will eventually become a busway, and work in the central business district, which is hub from all spokes in Brisbane. As such, bus and foot are my preferred commute modes. Ah but I should not gloat, as my smart card fare is about to increase by 20 percent in the New Year! And if the newspapers are to be believed, further substantial increments are proposed over the coming few years. This is reported to recoup some more of the costs of actually providing the quality public transport system that we enjoy in our region. So I expect it will be very interesting to see how transport economics will play out in reality in the coming few years, and how governments cater to Australians who either cannot afford substantial increases in transport costs or have no viable alternatives to those facilities whose costs will increase. The 2010 AITPM National Conference, “What’s New?”, still has the opportunity for authors to submit an abstract for consideration so please consider how you might contribute to the event. Best regards to all, Jon Bunker
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The function of CUB domain-containing protein 1 (CDCP1), a recently described transmembrane protein expressed on the surface of hematopoietic stem cells and normal and malignant cells of different tissue origin, is not well defined. The contribution of CDCP1 to tumor metastasis was analyzed by using HeLa carcinoma cells overexpressing CDCP1 (HeLa-CDCP1) and a high-disseminating variant of prostate carcinoma PC-3 naturally expressing high levels of CDCP1 (PC3-hi/diss). CDCP1 expression rendered HeLa cells more aggressive in experimental metastasis in immunodeficient mice. Metastatic colonization by HeLa-CDCP1 was effectively inhibited with subtractive immunization-generated, CDCP1-specific monoclonal antibody (mAb) 41-2, suggesting that CDCP1 facilitates relatively late stages of the metastatic cascade. In the chick embryo model, time- and dose-dependent inhibition of HeLa-CDCP1 colonization by mAb 41-2 was analyzed quantitatively to determine when and where CDCP1 functions during metastasis. Quantitative PCR and immunohistochemical analyses indicated that CDCP1 facilitated tumor cell survival soon after vascular arrest. Live cell imaging showed that the function-blocking mechanism of mAb 41-2 involved enhancement of tumor cell apoptosis, confirmed by attenuation of mAb 41-2–mediated effects with the caspase inhibitor z-VAD-fmk. Under proapoptotic conditions in vitro, CDCP1 expression conferred HeLa-CDCP1 cells with resistance to doxorubicin-induced apoptosis, whereas ligation of CDCP1 with mAb 41-2 caused additional enhancement of the apoptotic response. The functional role of naturally expressed CDCP1 was shown by mAb 41-2–mediated inhibition of both experimental and spontaneous metastasis of PC3-hi/diss. These findings confirm that CDCP1 functions as an antiapoptotic molecule and indicate that during metastasis CDCP1 facilitates tumor cell survival likely during or soon after extravasation.
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Gray‘s (2000) revised Reinforcement Sensitivity Theory (r-RST) was used to investigate personality effects on information processing biases to gain-framed and loss-framed anti-speeding messages and the persuasiveness of these messages. The r-RST postulates that behaviour is regulated by two major motivational systems: reward system or punishment system. It was hypothesised that both message processing and persuasiveness would be dependent upon an individual‘s sensitivity to reward or punishment. Student drivers (N = 133) were randomly assigned to view one of four anti-speeding messages or no message (control group). Individual processing differences were then measured using a lexical decision task, prior to participants completing a personality and persuasion questionnaire. Results indicated that participants who were more sensitive to reward showed a marginally significant (p = .050) tendency to report higher intentions to comply with the social gain-framed message and demonstrate a cognitive processing bias towards this message, than those with lower reward sensitivity.
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Driving and using prescription medicines that have the potential to impair driving is an emerging research area. To date it is characterised by a limited (although growing) number of studies and methodological complexities that make generalisations about impairment due to medications difficult. Consistent evidence has been found for the impairing effects of hypnotics, sedative antidepressants and antihistamines, and narcotic analgesics, although it has been estimated that as many as nine medication classes have the potential to impair driving (Alvarez & del Rio, 2000; Walsh, de Gier, Christopherson, & Verstraete, 2004). There is also evidence for increased negative effects related to concomitant use of other medications and alcohol (Movig et al., 2004; Pringle, Ahern, Heller, Gold, & Brown, 2005). Statistics on the high levels of Australian prescription medication use suggest that consumer awareness of driving impairment due to medicines should be examined. One web-based study has found a low level of awareness, knowledge and risk perceptions among Australian drivers about the impairing effects of various medications on driving (Mallick, Johnston, Goren, & Kennedy, 2007). The lack of awareness and knowledge brings into question the effectiveness of the existing countermeasures. In Australia these consist of the use of ancillary warning labels administered under mandatory regulation and professional guidelines, advice to patients, and the use of Consumer Medicines Information (CMI) with medications that are known to cause impairment. The responsibility for the use of the warnings and related counsel to patients primarily lies with the pharmacist when dispensing relevant medication. A review by the Therapeutic Goods Administration (TGA) noted that in practice, advice to patients may not occur and that CMI is not always available (TGA, 2002). Researchers have also found that patients' recall of verbal counsel is very low (Houts, Bachrach, Witmer, Tringali, Bucher, & Localio, 1998). With healthcare observed as increasingly being provided in outpatient conditions (Davis et al., 2006; Vingilis & MacDonald, 2000), establishing the effectiveness of the warning labels as a countermeasure is especially important. There have been recent international developments in medication categorisation systems and associated medication warning labels. In 2005, France implemented a four-tier medication categorisation and warning system to improve patients' and health professionals' awareness and knowledge of related road safety issues (AFSSAPS, 2005). This warning system uses a pictogram and indicates the level of potential impairment in relation to driving performance through the use of colour and advice on the recommended behaviour to adopt towards driving. The comparable Australian system does not indicate the severity level of potential effects, and does not provide specific guidelines on the attitude or actions that the individual should adopt towards driving. It is reliant upon the patient to be vigilant in self-monitoring effects, to understand the potential ways in which they may be affected and how serious these effects may be, and to adopt the appropriate protective actions. This thesis investigates the responses of a sample of Australian hospital outpatients who receive appropriate labelling and counselling advice about potential driving impairment due to prescribed medicines. It aims to provide baseline data on the understanding and use of relevant medications by a Queensland public hospital outpatient sample recruited through the hospital pharmacy. It includes an exploration and comparison of the effect of the Australian and French medication warning systems on medication user knowledge, attitudes, beliefs and behaviour, and explores whether there are areas in which the Australian system may be improved by including any beneficial elements of the French system. A total of 358 outpatients were surveyed, and a follow-up telephone survey was conducted with a subgroup of consenting participants who were taking at least one medication that required an ancillary warning label about driving impairment. A complementary study of 75 French hospital outpatients was also conducted to further investigate the performance of the warnings. Not surprisingly, medication use among the Australian outpatient sample was high. The ancillary warning labels required to appear on medications that can impair driving were prevalent. A subgroup of participants was identified as being potentially at-risk of driving impaired, based on their reported recent use of medications requiring an ancillary warning label and level of driving activity. The sample reported previous behaviour and held future intentions that were consistent with warning label advice and health protective action. Participants did not express a particular need for being advised by a health professional regarding fitness to drive in relation to their medication. However, it was also apparent from the analysis that the participants would be significantly more likely to follow advice from a doctor than a pharmacist. High levels of knowledge in terms of general principles about effects of alcohol, illicit drugs and combinations of substances, and related health and crash risks were revealed. This may reflect a sample specific effect. Emphasis is placed in the professional guidelines for hospital pharmacists that make it essential that advisory labels are applied to medicines where applicable and that warning advice is given to all patients on medication which may affect driving (SHPA, 2006, p. 221). The research program applied selected theoretical constructs from Schwarzer's (1992) Health Action Process Approach, which has extended constructs from existing health theories such as the Theory of Planned Behavior (Ajzen, 1991) to better account for the intention-behaviour gap often observed when predicting behaviour. This was undertaken to explore the utility of the constructs in understanding and predicting compliance intentions and behaviour with the mandatory medication warning about driving impairment. This investigation revealed that the theoretical constructs related to intention and planning to avoid driving if an effect from the medication was noticed were useful. Not all the theoretical model constructs that had been demonstrated to be significant predictors in previous research on different health behaviours were significant in the present analyses. Positive outcome expectancies from avoiding driving were found to be important influences on forming the intention to avoid driving if an effect due to medication was noticed. In turn, intention was found to be a significant predictor of planning. Other selected theoretical constructs failed to predict compliance with the Australian warning label advice. It is possible that the limited predictive power of a number of constructs including risk perceptions is due to the small sample size obtained at follow up on which the evaluation is based. Alternately, it is possible that the theoretical constructs failed to sufficiently account for issues of particular relevance to the driving situation. The responses of the Australian hospital outpatient sample towards the Australian and French medication warning labels, which differed according to visual characteristics and warning message, were examined. In addition, a complementary study with a sample of French hospital outpatients was undertaken in order to allow general comparisons concerning the performance of the warnings. While a large amount of research exists concerning warning effectiveness, there is little research that has specifically investigated medication warnings relating to driving impairment. General established principles concerning factors that have been demonstrated to enhance warning noticeability and behavioural compliance have been extrapolated and investigated in the present study. The extent to which there is a need for education and improved health messages on this issue was a core issue of investigation in this thesis. Among the Australian sample, the size of the warning label and text, and red colour were the most visually important characteristics. The pictogram used in the French labels was also rated highly, and was salient for a large proportion of the sample. According to the study of French hospital outpatients, the pictogram was perceived to be the most important visual characteristic. Overall, the findings suggest that the Australian approach of using a combination of visual characteristics was important for the majority of the sample but that the use of a pictogram could enhance effects. A high rate of warning recall was found overall and a further important finding was that higher warning label recall was associated with increased number of medication classes taken. These results suggest that increased vigilance and care are associated with the number of medications taken and the associated repetition of the warning message. Significantly higher levels of risk perception were found for the French Level 3 (highest severity) label compared with the comparable mandatory Australian ancillary Label 1 warning. Participants' intentions related to the warning labels indicated that they would be more cautious while taking potentially impairing medication displaying the French Level 3 label compared with the Australian Label 1. These are potentially important findings for the Australian context regarding the current driving impairment warnings about displayed on medication. The findings raise other important implications for the Australian labelling context. An underlying factor may be the differences in the wording of the warning messages that appear on the Australian and French labels. The French label explicitly states "do not drive" while the Australian label states "if affected, do not drive", and the difference in responses may reflect that less severity is perceived where the situation involves the consumer's self-assessment of their impairment. The differences in the assignment of responsibility by the Australian (the consumer assesses and decides) and French (the doctor assesses and decides) approaches for the decision to drive while taking medication raises the core question of who is most able to assess driving impairment due to medication: the consumer, or the health professional? There are pros and cons related to knowledge, expertise and practicalities with either option. However, if the safety of the consumer is the primary aim, then the trend towards stronger risk perceptions and more consistent and cautious behavioural intentions in relation to the French label suggests that this approach may be more beneficial for consumer safety. The observations from the follow-up survey, although based on a small sample size and descriptive in nature, revealed that just over half of the sample recalled seeing a warning label about driving impairment on at least one of their medications. The majority of these respondents reported compliance with the warning advice. However, the results indicated variation in responses concerning alcohol intake and modifying the dose of medication or driving habits so that they could continue to drive, which suggests that the warning advice may not be having the desired impact. The findings of this research have implications for current countermeasures in this area. These have included enhancing the role that prescribing doctors have in providing warnings and advice to patients about the impact that their medication can have on driving, increasing consumer perceptions of the authority of pharmacists on this issue, and the reinforcement of the warning message. More broadly, it is suggested that there would be benefit in a wider dissemination of research-based information on increased crash risk and systematic monitoring and publicity about the representation of medications in crashes resulting in injuries and fatalities. Suggestions for future research concern the continued investigation of the effects of medications and interactions with existing medical conditions and other substances on driving skills, effects of variations in warning label design, individual behaviours and characteristics (particularly among those groups who are dependent upon prescription medication) and validation of consumer self-assessment of impairment.
