Pain relief for neonates in Australian hospitals: A need to improve evidence-based practice

Objective: To ascertain the extent to which neonatal analgesia was used in Australia for minor invasive procedures as an indicator of evidence-based practice in neonatology. Methods: A cross-sectional telephone survey of hospitals in all Australian states and territories with more than 200 deliveries per year was carried out. Questions were asked regarding awareness of the benefits and the use of analgesia for minor invasive procedures in term and near term neonates. Analysis was undertaken according to state and territory, annual birth numbers and the level of neonatal nursery care available. Results: Data were available from 212 of 214 eligible hospitals. Of the total respondents, 51% and 70% respectively were aware of the benefits of sucrose and breast-feeding for neonatal analgesia. Eleven per cent of units administered sucrose before venepuncture and 25% of units used breast-feeding. Ten per cent of units used sucrose before heel prick with 49% utilizing breast-feeding. Expressed breast milk was used in 10% of units. Analgesia was given less frequently before intravenous cannulation compared to venepuncture and heel prick. Awareness and implementation of neonatal analgesia varied widely in the states and territories. There was a trend for hospitals providing a higher level of neonatal care to have a greater awareness of sucrose as an analgesic (P < 0.0001) and the use of sucrose for venepuncture (P = 0.029), heel prick (P = 0.025) and intravenous catheter insertion (P = 0.013). Similar trends were found on analysis according to birth number of the maternity units. Smaller units had a greater usage of breast-feeding as an analgesic for heel prick (P = 0.017). Conclusion: Despite good evidence for the administration of sucrose and breast milk in providing effective analgesia for newborn infants, it is not widely used in Australia. It is imperative that the gap between research findings and clinical practice with regard to neonatal analgesia be addressed.

Smoking status of Australian general practice patients and their attempts to quit

This paper seeks to report on smoking rates, quit attempt methods and success rates among adult patients attending Australian general practice. A cluster cross-sectional survey was used to survey adult patients (18+), who attended Australian GPs in during 2002 and 2003. Over a quarter of patients (27.3%; 95% CI: 26.0-28.7) were former smokers and one in five (21.5%; 95% CI: 20.1-22.9) were current smokers. Ninety-two percent of former and 80% of current smokers used only one method in their last quit attempt with cold turkey the most common method used by both former (88%) and current (62%) smokers. Overall, success rates varied from 77% for cold turkey to 23% for bupropion. Success rates were re-analysed to consider quit attempts post-bupropion listing, with success rate for cold turkey reduced to 40% while bupropion remained reasonably constant at 21%. By tailoring smoking cessation interventions to a smokers' preparedness to quit, scope exists to increase the pool of smokers offered strategies that are more effective in achieving abstinence and avoiding relapse rather than relying on less effective self-quitting behaviours such as cold turkey. (c) 2005 Elsevier Ltd. All rights reserved.

Beneficial associations of physical activity with 2-h but not fasting blood glucose in Australian adults

OBJECTIVE - We examined the associations of physical activity with fasting plasma glucose (FPG) and with 2-h postload plasma glucose (2-h PG) in men and women with low, moderate, and high waist circumference. RESEARCH DESIGN AND METHODS - The Australian Diabetes, Obesity and Lifestyle (AusDiab) study provided data on a population-based cross-sectional sample of 4,108 men and 5,106 women aged >= 25 years without known diabetes or health conditions that could affect physical activity. FPG and 2-h PG were obtained from an oral glucose tolerance test. Self-reported physical activity level was defined according to the current public health guidelines as active (>= 150 min/week across five or more sessions) or inactive (< 150 min/week and/or less than five sessions). Sex-specific quintiles of physical activity time were used to ascertain dose response. RESULTS - Being physically active and total physical activity time were independently and negatively associated with 2-h PG. When physical activity level was considered within each waist circumference category, 2-h PG was significantly lower in active high-waist circumference women (beta-0.30 [95% CI -0.59 to -0.01], P = 0.044) and active low-waist circumference men(beta-0.25 [-0.49 to -0.02],P = 0.036) compared with their inactive counterparts. Considered across physical activity and waist circumference categories, 2-h PG levels were not significantly different between active moderate-waist circumference participants and active low-waist circumference participants. Associations between physical activity and FPG were nonsignificant. CONCLUSIONS - There are important differences between 2-h PG and FPG related to physical activity. It appears that 2-h PG is more sensitive to the beneficial effects of physical activity, and these benefits occur across the waist circumference spectrum.

Homing devices in choice of Tort Law: Australian, British and Canadian Approaches

Since 1994, Canada, the United Kingdom and Australia have adopted new choice of law rules for cross-border torts that, in different ways, centre on the application of the law of the place where the tort occurred (the lex loci delicti). All three countries abandoned some species of the rule in Phillips v Eyre, which required some reference to the law of the forum (the lex fori) as well as the lex loci delicti. However, predictions were made that, where possible, courts in these countries would continue to show a strong inclination to apply the lex fori in cross-border tort cases - and would use a range of homing devices to do so. A comprehensive survey and analysis of the cases that have been decided under the Australian, British and Canadian lex loci delicti regimes suggests that courts in these countries do betray a homing instinct, but one that has actually been tightly restrained by appeal courts. Where application of the lex fori was formally allowed by use of a 'flexible exception' in Canada and the United Kingdom, this has been contained by courts of first appeal. Indeed, only the continuing characterization of the assessment of damages as a procedural question in Canada and the United Kingdom, seems to remain as a significant homing device for courts in these countries. © 2006 Oxford University Press.

How does the health and well-being of young Australian vegetarian and semi-vegetarian women compare with non-vegetarians?

Objective: To compare the sociodemographic characteristics, health status and health service use of vegetarians, semi-vegetarians and non-vegetarians. Design: In cross-sectional data analyses of the Australian Longitudinal Study on Women's Health in 2000, 9113 women (aged 22-27 years) were defined as non-vegetarians if they reported including red meat in their diet., as semi-vegetarians if they excluded red meat and as vegetarians if they excluded meat, poultry and fish from their diet. Results: The estimated prevalence was 3% and 10% for vegetarian and semi-vegetarian young women. Compared with non-vegetarians, vegetarians and semi-vegetarians were more likely to live in urban areas and to not be married. Vegetarians and semi-vegetarians had lower body mass index (mean (95% confidence interval): 22.2 (21.7-22.7) and 23.0 (22.7-23.3) kg m(-2)) than non-vegetarians (23.7 (23.6-23.8) kg m(-2)) and tended to exercise more. Semi-vegetarians and vegetarians had poorer mental health, with 21-22% reporting depression compared with 15% of non-vegetarians (P < 0.001). Low iron levels and menstrual symptoms were also more common in both vegetarian groups. Vegetarian and semi-vegetarian women were more likely to consult alternative health practitioners and semi-vegetarians reported taking more prescription and non-prescription medications. Compared with non-vegetarians, semi-vegetarians were less likely and vegetarians much less likely to be taking the oral contraceptive pill. Conclusion: The levels of physical activity and body mass indices of the vegetarian and semi-vegetarian women suggest they are healthier than non-vegetarians. However, the greater reports of menstrual problems and the poorer mental health of these young women may be of clinical significance.

Danger zones and hot spots: Traversing Canadian and Australian narratives of urban multiculturalism

The ethnicity of urban space has long been an element in the burgeoning discourse of national multiculturalisms; so much so that spatial theorist Edward Soja uses the term “ethni-city” to speak of so-called postmodern or postcolonial urban geographies (239). In our focus on the urban, we point to both the conceptual and material thresholds of multiculturalism within the borders of the city, as well as the internal urban/suburban borders that delineate belonging. These are often as strongly patrolled as larger national borders. In taking up Sneja Gunew’s call in Haunted Nations for comparative and critical work on multiculturalisms, this paper offers preliminary and exploratory avenues and points of departure, and aims to particularise the multicultural as an encounter and experience that is regulated spatially and corporeally.

Cross-language Perception of Word-final Stops by Native Vietnamese Listeners: Preliminary Results on the Role of Specific, Non-native Phonetic Experience

This study examined the discrimination of word-final stop contrasts (/p/-/t/, /p/-/k/, /t/-/k/) in English and Thai by 12 listeners who speak Vietnamese as their first language (L1). Vietnamese shares specific phonetic realization of stops with Thai, i.e., unreleased final stop and differs from English which allows both released and unreleased final stops. These 12 native Vietnamese (NV) listeners’ discrimination accuracy was compared to that of the two listener groups (Australian English (AE), native Thai (NT)) tested in previous studies. The NV group was less accurate than the native group in discriminating both English and Thai stop contrasts. In particular, for the Thai /t/-/k/ contrast, they were significantly less accurate than the AE listeners. The present findings suggest that experience with specific (i.e., unreleased) and native phonetic realization of sounds may be essential in accurate discrimination of final stop contrasts. The effect of L1 dialect on cross-language speech perception is discussed.

Cross country comparison of careers in logistics management in Australia and Britain

Purpose – The aim of this research was to ascertain the current roles and responsibilities of logistics managers in two countries, how they compare their situation with other managers and to identify the types of knowledge and experience that would assist them to develop their careers. Design/methodology/approach – This paper compares the results of a postal survey of 303 Australian and 161 British logistics managers. Findings – The study indicates that logistics managers in both countries share many similar experiences, responsibilities and perceptions of their career situations. They take considerable pride and satisfaction from these careers but recognise the need for continuing professional development in their present and future roles. Research limitations/implications – The research is limited to the respondents to the surveys. Further research in other countries including less well-developed economies would add to the generalisation of results. Practical implications – It is argued that for successful international supply chain management, there is a need to review both current and future provision in higher education and continuing professional development, in order to strengthen strategic competences and increase understanding of the significance of interdisciplinary awareness in global markets. Originality/value – This paper represents the first attempt to understand the roles, responsibilities, career pathways and future needs of logistics managers in the two countries. Its results should provide guidance to top managers for the future success of the logistics function in their organisations.

Production and operations managers and logistics managers: a cross-country comparison

Purpose – The purpose of this paper is to explore the contribution of production and operations managers (POMs) and logistics managers (LMs) in improving manufacturing and service operations, comparing experiences in Australia and Britain. Design/methodology/approach – The findings are based on surveys of the two occupations in the two countries. Thus, the focus is on comparing and contrasting two strategically placed occupations within the supply chain and in two traditional manufacturing economies in developed countries, in opposing hemispheres of the world. Findings – The working lives of 254 Australian and 195 British POMs and 303 Australian and 168 British LMs are explored to see how well prepared they are for the business challenges of today, whether they see the need for changes in the ways in which they work and what satisfactions they derive from their worlds of work? Practical implications – Insights are provided for senior management into the deployment and personal and professional development needs of two key occupations within supply chain management. Originality/value – The findings from the research give fresh insights into the ways in which managers in the two areas of responsibilities in the two countries.view their worlds of work.