The effectiveness of designated driver programs

Designated driver programs aim to reduce alcohol related crashes by encouraging and facilitating a safe means of transport for those who have been drinking and by influencing attitudes and knowledge. This review discusses the use and effectiveness of designated driver programs in preventing drink driving and ultimately reducing alcohol related road trauma. The limitations of studies examining designated driver programs and recommendations for further research are also discussed. The available evidence suggests that while designated driver campaigns can successfully increase the awareness and use of designated drivers, it is less clear whether these programs lead to a reduction in drink driving and/or alcohol related crashes. Differences in the way that designated driver programs have historically been implemented may account for the inconsistent evidence for their effectiveness in reducing drink driving. There are also a variety of methodological problems relating to the evaluation of designated driver programs which need to be addressed by future research.

Schools' guide : How to select providers of road safety education programs for senior school students

Road safety education is not just about safe driving. Best practice road safety education seeks to improve knowledge and change attitudes relating to being safe, and making sure others are safe on the road. Typical topics might include: • Strengthening attitudes toward safe road use behaviours and avoiding risks • Supporting behaviours to ensure others are safe • Promoting knowledge of traffic rules.

Marketing unions to young people : recruiting and ‘rusting on’

In light of declining trade union density, specifically amongst young workers, this paper explores how trade unions are servicing and organising young people. Our specific focus is the way in which trade unions market their services to the young. We use, as a lens of analysis, the services marketing literature and the concept of an ‘experience good’ to explore trade union strategies. Based on interviews with a number of Queensland union officials, it is clear unions see the issue of recruitment of young people as significant, and that resources are being targeted on the development of innovative strategies at least in some unions.

The Impact of Experiential Learning in Enhancing Palliative Care Knowledge and Skills among Nurses

Nurses working in community settings are increasingly required to care for people with chronic, life limiting conditions. Innovative educational programs are required to ensure nurses are equipped to deal with this challenging area of practice. The Program of Experience in the Palliative Approach (PEPA) started in 2003 as an initiative of the Australian Government, Department of Health and Ageing. The overall aim of PEPA is to improve the quality, availability and access to palliative care for people who are dying, and their families, by improving the skills and expertise of health practitioners, and enhancing collaboration between primary and specialist palliative care services. PEPA provides nurses with an opportunity to develop knowledge and skills in the palliative approach to care through funded clinical workforce placements or workshops.

Levels of cardiac knowledge and cardiopulmonary resuscitation training among older people in Queensland

Objectives: The current study was conducted to determine levels of cardiac knowledge and cardiopulmonary resuscitation (CPR) training in older people in Queensland, Australia.---------- Methods: A telephone survey of 4490 Queensland adults examined respondents’ knowledge of coronary heart disease (CHD) risk factors, knowledge of heart attack symptoms, knowledge of the local emergency telephone number, as well as respondents’ rates and recency of training in CPR.---------- Results: Older participants, aged 60 years and over, were approximately one and a half times more likely than the 30–39 year-old reference group to have limited knowledge of heart disease risk factors (OR = 1.53), and low knowledge of heart attack symptoms (OR = 1.60). Knowledge of the local emergency telephone number also decreased with age. Older participants had significantly lower rates of training in CPR, with almost three quarters (71.7%) reporting that they had never been trained. Older people who had completed CPR training were significantly less likely to have done so recently.---------- Conclusions: Cardiac knowledge levels and CPR training rates in older Queensland persons were lower than those found in the younger population.

Developing capabilities for ongoing learning and change in intermediary programs

In dynamic environments, firms seek to build capabilities which will permit them to become innovation and change ready. Programs offered by intermediaries, while varying greatly in content and format, are designed to support those firms wishing to enhance their competitiveness. Firms which participate in intermediary programs have displayed their willingness to overcome deficiencies or barriers to competitiveness through acquiring knowledge which is external to the firm. This paper reports on interviews with 24 firms who were involved in a MAP or TAP program offered by QMI Solutions. The findings of the research suggest that knowledge intermediaries serve to disrupt organisational paths and in so doing establish mechanisms for ongoing learning and change. They do this first by disrupting the firm with a positive learning experience and also by establishing processes for developing new relationships and access to knowledge which are critical for learning and change. It is the experience of learning through knowledge exchange which can trigger the pursuit of new paths and it is the processes involving new relations and knowledge processing that provides the micro-foundations for ongoing learning and change. This suggests that the role of intermediaries goes well beyond merely knowledge transfer to include longer term effects on the capability of organisations to innovate, which is critical to economic competitiveness and the survival rate of firms.

Poor functional health literacy : the silent disability for older people

In this information age, people are confronted by verbal, visual and written information. This is especially important in the health field, where information is needed to follow directions, understand prescriptions and undertake preventive behaviours. If provided in written form, much of this information may be inaccessible to people who cannot adequately read. Although poor literacy skills affect all groups in the population, older adults with fewer years of education seem to be particularly disadvantaged by an increasing reliance on written communication of health information. With older age comes a higher risk of illness and disability and a greater potential need to access the health system. As a result, poor literacy skills of older individuals may directly impact their health status. This paper explores the link between functional literacy and health, particularly for the older population, provides strategies to practitioners for the management of this problem, and suggests research initiatives in this area.

Identifying programs to reduce road trauma to A.C.T. motorcyclists

A broad range of motorcycle safety programs and systems exist in Australia and New Zealand. These vary from statewide licensing and training systems run by government licensing and transport agencies to safety programs run in small communities and by individual rider groups. While the effectiveness of licensing and training has been reviewed and recommendations for improvement have been developed (e.g. Haworth & Mulvihill, 2005), little is known about many smaller or innovative programs, and their potential to improve motorcycle safety in the ACT.

Teaching young people first aid skills to reduce injury

Background First aid given immediately after a motor vehicle crash can have considerable benefits. Less understood however is first aid training as a prevention strategy for reducing risk-taking. A first step is to understand whether first aid skills are associated with risk-taking and injury experiences. Further, students and teachers who undergo or deliver such training offer important perspectives about implementation. Aims The research has two aims: (i) to identify whether first aid knowledge is associated with road risk-taking and injury and (ii) to examine teachers’ and students’ experiences of first aid activities within a school-based injury prevention and control program. Method Participants were 173 Year 9s (47% male) who completed a survey which included demographic information, first aid knowledge and risk-taking behaviour and injury experiences. Focus groups were held with 8 teachers who delivered, and 70 students who participated in, a school-based injury prevention and control program. Results Results showed a relationship between greater first aid knowledge and reduced engagement in risk-taking and injury experiences. Both students and teachers reported favourably on first aid however teachers also acknowledged challenges in delivering practical activities. Discussion & Conclusion It appears that first aid can be implemented within the school setting, particularly at the Year 9 level, and that both students and teachers involved in such training identify multiple benefits and positive experiences with first aid training. In addition, the findings suggest that first aid knowledge could be an important part of a prevention program.

The importance of school connectedness in adolescent risk taking and injury prevention

Background: Injury is the leading cause of mortality for young people in Australia (AIHW, 2008). Adolescent injury mortality is consistently associated with risk taking behaviour, including transport and interpersonal violence (AIHW, 2003), which often occurs in the context of alcohol and other substance use. A rapid increase in risk taking and injury through early to late adolescence highlights the need for effective school based interventions. Aim: The aim of the current research was to examine the relationship between school connectedness and adolescent risk and injury, in order to inform effective prevention approaches. School connectedness, or students’ feelings of belongingness to school, has been shown to be a critical protective factor in adolescence which can be targeted effectively through teacher interventions. Despite evidence linking low school connectedness with increased health risk behaviour, including substance use and violence, research has not yet addressed possible links between connectedness and a broader range of risk taking behaviours (e.g. transport risks) or injury. Method: This study involved background data collection to inform the development of an intervention. A total of 595 Year 9 students (aged 13-14 years) from 5 Southeast Queensland high schools completed questionnaires that included measures of school connectedness, risk taking behaviour, alcohol and other substance use, and injuries. Results: Increased school connectedness was found to be associated with fewer transport risk behaviours and with decreased alcohol and other substance use for both males and females. Similarly, increased school connectedness was associated with fewer passenger and motorcycle injuries for male participants. Both males and females with increased school connectedness reported fewer alcohol related injuries. Implications: These results indicate that school connectedness appears to have protective effects for early adolescence. These findings may also hold for older adolescents and indicate that it may be an important factor to target in school based risk and injury prevention programs. A school connectedness intervention is currently being designed, focusing on teacher professional development. The intervention will be implemented in conjunction with a curriculum based injury prevention program for Year 9 students and will be evaluated through a large scale cluster randomised trial involving 26 schools.

The impact of pain on the quality of life of people with multiple sclerosis: A community survey

The purpose of this study was to examine the impact of pain on functioning across multiple quality of life (QOL) domains among individuals with multiple sclerosis (MS). A total of 219 people were recruited from a regional MS society membership database to serve as the community-based study sample. All participants completed a questionnaire containing items about their demographic and clinical characteristics, validated measures of QOL and MS-related disability, and a question on whether or not they had experienced clinically significant pain in the preceding 2 weeks. Respondents who reported pain then completed an in-person structured pain interview assessing pain characteristics (intensity, quality, location, extent, and duration). Comparisons between participants with and without MS-related pain demonstrated that pain prevalence and intensity were strongly correlated with QOL: physical health, psychological health, level of independence, and global QOL were more likely to be impaired among people with MS when pain was present, and the extent of impairment was associated with the intensity of pain. Moreover, these relationships remained significant even after statistically controlling for multiple demographic and clinical covariates associated with self-reported QOL. These findings suggest that for people with MS, pain is an important source of distress and disability beyond that caused by neurologic impairments.

End-of-life decision making for older people

This chapter deals with the increasing issues surrounding end-of-life decision making. As the life trajectory for older people changes, the need for open discussion about their health problems and treatment becomes more critical. Acceptance of the ageing process itself is often not easy so the matter of a good death is even more distressing for some people to consider. The vignette provides an excellent discussion on the need for open dialogue with the older person and their families, whether they are acutely ill or have chronic health problems. How a person wishes to be treated when quality of life is not going to improve, no matter what interventions are put in place, seems essential for person-centred care. The issue of competency is one that must be determined before any decision is made by any person involved in care.

Knowing a donor and identifying as one : determinants of people's willingness for related and anonymous living donation in Australia

While LRD (living donation to a genetically/emotionally related recipient) is well established in Australia, LAD (living anonymous donation to a stranger) is rare. Given the increasing use of LAD overseas, Australia may likely follow suit. Understanding the determinants of people’s willingness for LAD is essential but infrequently studied in Australia. Consequently, we compared the determinants of people’s LRD and LAD willingness, and assessed whether these determinants differed according to type of living donation. We surveyed 487 health students about their LRD and LAD willingness, attitudes, identity, prior experience with blood and organ donation, deceased donation preference, and demographics. We used Structural Equation Modelling (SEM) to identify the determinants of willingness for LRD and LAD and paired sample t-tests to examine differences in LRD and LAD attitudes, identity, and willingness. Mean differences in willingness (LRD 5.93, LAD 3.92), attitudes (LRD 6.43, LAD 5.53), and identity (LRD 5.69, LAD 3.58) were statistically significant. Revised SEM models provided a good fit to the data (LRD: x2 (41) = 67.67, p = 0.005, CFI = 0.96, RMSEA = 0.04; LAD: x2 (40) = 79.64, p < 0.001, CFI = 0.95, RMSEA = 0.05) and explained 45% and 54% of the variation in LRD and LAD willingness, respectively. Four common determinants of LRD and LAD willingness emerged: identity, attitude, past blood donation, and knowing a deceased donor. Religious affiliation and deceased donation preference predicted LAD willingness also. Identifying similarities and differences in these determinants can inform future efforts aimed at understanding people’s LRD and LAD willingness and the evaluation of potential living donor motives. Notably, this study highlights the importance of people’s identification as a living donor as a motive underlying their willingness to donate their organs while living.

Living walls - a way to green the built environment

Actions Towards Sustainable Outcomes Environmental Issues/Principal Impacts The increasing urbanisation of cities brings with it several detrimental consequences, such as: • Significant energy use for heating and cooling many more buildings has led to urban heat islands and increased greenhouse gas emissions. • Increased amount of hard surfaces, which not only contributes to higher temperatures in cities, but also to increased stormwater runoff. • Degraded air quality and noise. • Health and general well-being of people is frequently compromised, by inadequate indoor air quality. • Reduced urban biodiversity. Basic Strategies In many design situations, boundaries and constraints limit the application of cutting EDGe actions. In these circumstances, designers should at least consider the following: • Living walls are an emerging technology, and many Australian examples function more as internal feature walls. However,as understanding of the benefits and construction of living walls develops this technology could be part of an exterior facade that enhances a building’s thermal performance. • Living walls should be designed to function with an irrigation system using non-potable water. Cutting EDGe Strategies • Living walls can be part of a design strategy that effectively improves the thermal performance of a building, thereby contributing to lower energy use and greenhouse gas emissions. • Including living walls in the initial stages of design would provide greater flexibility to the design, especially of the facade, structural supports, mechanical ventilation and watering systems, thus lowering costs. • Designing a building with an early understanding of living walls can greatly reduce maintenance costs. • Including plant species and planting media that would be able to remove air impurities could contribute to improved indoor air quality, workplace productivity and well-being. Synergies and References • Living walls are a key research topic at the Centre for Subtropical Design, Queensland University of Technology: http://www.subtropicaldesign.bee.qut.edu.au • BEDP Environment Design Guide: DES 53: Roof and Facade Gardens • BEDP Environment Design Guide: GEN 4: Positive Development – Designing for Net Positive Impacts (see green scaffolding and green space frame walls). • Green Roofs Australia: www.greenroofs.wordpress.com • Green Roofs for Healthy Cities USA: www.greenroofs.org