Drinking and riding: is subjective workload related to performance?

Introduction: Within the context of road safety it is important that workload (the portion of a driver���s resources expended to perform a task) remains at a manageable level, preventing overloading and consequently performance decrements. Motorcyclists are over represented in crash statistics where the vehicle operator has a positive, low blood alcohol concentration (BAC) (e.g., ���0.05%). The NASA task load index (NASA-TLX) comprises sub-scales that purportedly assess different aspects of subjective workload. It was hypothesized that, compared to a zero BAC condition, low BACs would be associated with increases in workload ratings, and decrements in riding performance. Method: Forty participants (20 novice, 20 experienced) completed simulated motorcycle rides in urban and rural scenarios under low dose BAC conditions (0.00%, 0.02%, 0.05% BAC), while completing a safety relevant peripheral detection task (PDT). Six sub-scales of the NASA-TLX were completed after each ride. Riding performance was assessed using standard deviation of lateral position (SDLP). Hazard perception was assessed by response time to the PDT. Results: Riding performance and hazard perception were affected by alcohol. There was a significant increase in SDLP in the urban scenario and of PDT reaction time in the rural scenario under 0.05% BAC compared to 0.00% BAC. Overall NASA-TLX score increased at 0.02% and 0.05% BAC in the urban environment only, with a trend for novices to rate workload higher than experienced riders. There was a significant main effect of sub-scale on workload ratings in both the urban and rural scenarios. Discussion: 0.05% BAC was associated with decrements in riding performance in the urban environment, decrements in hazard perception in the rural environment, and increases in overall ratings of subjective workload in the urban environment. The workload sub-scales of the NASA-TLX appear to be measuring distinct aspects of motorcycle riding-related workload. Issues of workload and alcohol impaired riding performance are discussed.

Experiences of regional and rural people with cancer being treated with radiotherapy in a metropolitan centre

This paper explores the issues related to rural people with cancer whose choice of radiotherapy treatment necessitated travel and accommodation in a metropolitan centre. Semi-structured interviews with 46 participants, from the Toowoomba and Darling Downs region of Queensland, Australia, were conducted and the data thematically analysed. The specific themes identified were: being away from loved ones, maintaining responsibilities whilst undergoing treatment, emotional stress, burden on significant others, choice about radiotherapy as a treatment, travel and accommodation, and financial burden. This study supports the need for a radiotherapy centre in the location of Toowoomba as a way of providing some equity and access to such treatment for the rural people of Queensland.

A review of the educational needs of nurses administering cancer chemotherapy in rural and remote areas of Queensland

This paper describes current issues in chemotherapy nursing practice in rural and remote Australia. There is a trend to refer chemotherapy clients back to their rural and remote health facility for treatment from major oncology centres in Australia. However, it is increasingly apparent that the majority of nurses administering chemotherapy in smaller centres lack the theoretical and clinical knowledge to ensure optimum client outcomes and nurse/client safety. There are also issues unique to rural and remote life which will influence optimum chemotherapy service delivery. The research program described in the paper will ascertain the education requirements of rural and remote nurses administering chemotherapy and the design and delivery of a chemotherapy education package specific to the rural and remote context. Similar programs will ensure the best standards of chemotherapy practice in non-metropolitan areas by enhancing the practical and theoretical knowledge base of rural and remote nurses.

Retaining rural and remote area nurses : The Queensland, Australia experience

Because higher-than-average turnover rates for nurses who work in remote and rural areas are the norm, the authors conducted a study to identify professional and personal factors that influenced rural nurses��� decisions to resign. Using a mail survey, the authors gathered qualitative and quantitative data from nurses who had resigned from rural and remote areas in Queensland, Australia. Their findings, categorized into professional and rural influences, highlight the importance of work force planning strategies that capitalize on the positive aspects of rural and remote area practice, to retain nurses in nonmetropolitan areas.

Analysis on causes of death of rural residents in Shouguang City [������������������������������������������]

Among people living in rural areas of Shouguang City, Shandong, China, 88% of deaths were caused by chronic non-communicable diseases. Cardiovascular diseases, respiratory diseases and cancers accounted for 97% of all chronic disease causes and 85% of all causes of death. The proportion of chronic causes increased by 27% from 1993 to 2000. However, the mortality of respiratory diseases showed a decreasing trend over time. Abstract in Chinese ��������� ���������������������������,���������������������������������������������������������������������,������������������������������������,���������������������������������������������������������,���������������������������������������1993���2000������������������������������������������.

Cuases of death among rural residents in Shouguang City, 1993-1997 [���������1993���1997���������������������������]

In this rural population, cardiovascular diseases, respiratory diseases, cancers and injuries were identified as the major causes of death, responsible for 34%, 30%, 20% and 9%, respectively. Abstract in Chinese ���������������������������������,���������������������,���������������������������������������������������������������������������������������������,������������������������������������1993~1997������������������������������������������������������������1993������,������������������������������������������49���������������5000..

Acute poststreptococcal glomerulonephritis : public health implications of recent clusters in New South Wales and epidemiology of hospital admissions

Acute poststreptococcal glomerulonephritis (APSGN) is an inflammatory kidney condition that can complicate Group A streptococcal infections. Two clusters of APSGN occurred recently in New South Wales (NSW), Australia; one in a rural town in December 1999 and the other in a Sydney suburb in January 2000. We interviewed carers of the affected children but found no common exposures except three of the Sydney cases were cousins in frequent contact. To assess the probability of these clusters occurring, we analysed hospital admissions for acute glomerulonephritis, as a proxy for APSGN in younger patients. The incidence of acute glomerulonephritis in NSW during 1989/90-1997/8 in residents aged under 20 years was 2(.)2/100000/year (95% CI 2(.)0-2(.)5). Incidence was highest in children aged 5-9 years, boys and Aboriginal children. We found no evidence for other clusters during that period. The recent clusters highlight the continued potential for unexpected future outbreaks of APSGN.

Building Healthy Communities : GP Network, Medicare Local and Primary Health Care in the Wheatbelt Region of Western Australia

��� Government reports consistently recognise the importance of Primary Health Care to an efficient health system. Barriers identified in Australia���s Primary Health Care include workforce pressures, increase rate of chronic disease, and equitable access to Primary Health Care services. ��� General Practitioners (GPs) are the key to the successful delivery of Primary Health Care especially in rural and remote regions such as the Wheatbelt region in Western Australia (WA). ��� The Wheatbelt region of WA is vast: some 72,500 residents spread across 150,000km2 in 43 Local Government Authorities catchments. Majority of the Wheatbelt residents live in small towns. There is a higher reported rates of chronic disease, more at risk of chronic diseases and less utilisation of Primary Health Care services in this region. ��� General practice patients in the Wheatbelt are among those most in need of Primary Health Care services. ��� Wheatbelt GP Network (the ���Network���) was established in 1998. It is a key health service delivery stakeholder in the Wheatbelt. ��� The Network has responded to the health needs of the community by creating a mobile Allied Health Team that works closely with GPs and is adaptive to ensure priority needs are met. ��� The Medicare Local model introduced by the Australian Government in 2011 aimed to improve the delivery of Primary Health Care services by improved health planning and coordinating service delivery. ��� Little if any recognition has been given to the outstanding work that many Divisions of General Practice have done in improving the delivery of Primary Health Care services such as the Network. ��� The Network has continued to support GPs and general practices and created a complementary system that integrated general practice with the work of an Allied Health Team. Its program mix is extensive. ��� The Network has consistently delivered on-required contract outputs and has a fifteen (15) years history of operating successfully in a large geographical area comprising in the main smaller communities that cannot support the traditional health services model. ��� The complexity of supporting International Medical Graduates in the region requires special attention. ��� The introduction of the Medicare Local in the South West of WA and their intention to take over the delivery of health services, thus effectively shutting the Network will have catastrophic consequences and cannot be supported economically. ��� The Network proposes to create a new model, built on its past work that increases the delivery of Primary Health Care services through its current Allied Health Team. ��� The proposal uses the Wheatbelt GP Super Clinic currently under construction in Northam, part of the Network and funded by the Australian Government is a key to the proposed new model. ��� Wheatbelt GP Super Clinic is different from existing models of GP Super Clinics around Australia which focus predominately on co-location of services. Wheatbelt GP Super Clinic utilises a hub and spoke model of service outreach to small rural towns to ensure equitable Primary Health Care coverage and continuum of care in a financially responsible and viable manner. In particular, the Wheatbelt GP Super Clinic recognises the importance of Allied Health Professionals and will involve them in a collaborative model with rural general practice. ��� The proposed model advocated by the Network aims to substitute the South West WA Medicare Local direct service delivery proposed for the Wheatbelt. The Network���s proposed model is to expand on the current hub and spoke model of Primary Health Care delivery to otherwise small unviable Wheatbelt towns. A flexible and adaptive skill mix of Allied Health Professionals, Nurse Practitioners and GPs ensure equitable access to service. Expanded scope of practices are utilised to reduce duplication of service and concentration of services in major towns. This involves a partnership approach. ��� If the proposed model not funded, the Network and the Wheatbelt region will stand to lose 16 Allied Health Professionals and defeats the purpose of Australian Government current funding for the construction of the Wheatbelt GP Super Clinic. ��� The Network has considered how its model can best be funded. It proposes a re-allocation of funds made available to the South West WA Medicare Local. ��� This submission argues that the proposal for the South West WA Medicare Local to take over the service delivery of Primary Health Care services in the Wheatbelt makes no economic sense when an existing agency (the Network) has the infrastructure in place, is experienced in working in this geographical area that has special needs and is capable to expand its programs to meet demand.

Shrinkage empirical likelihood estimator in longitudinal analysis with time-dependent covariates-application to modeling the health of Filipino children

The method of generalized estimating equations (GEE) is a popular tool for analysing longitudinal (panel) data. Often, the covariates collected are time-dependent in nature, for example, age, relapse status, monthly income. When using GEE to analyse longitudinal data with time-dependent covariates, crucial assumptions about the covariates are necessary for valid inferences to be drawn. When those assumptions do not hold or cannot be verified, Pepe and Anderson (1994, Communications in Statistics, Simulations and Computation 23, 939���951) advocated using an independence working correlation assumption in the GEE model as a robust approach. However, using GEE with the independence correlation assumption may lead to significant efficiency loss (Fitzmaurice, 1995, Biometrics 51, 309���317). In this article, we propose a method that extracts additional information from the estimating equations that are excluded by the independence assumption. The method always includes the estimating equations under the independence assumption and the contribution from the remaining estimating equations is weighted according to the likelihood of each equation being a consistent estimating equation and the information it carries. We apply the method to a longitudinal study of the health of a group of Filipino children.

Community health workers' response to violence against women

This paper reports on a qualitative study of community health workers from a predominantly rural based region in Queensland. The purpose of this study was to determine the community health worker barriers to identification, assessment and intervention on the issue of violence against women. The qualitative research method comprised five structured focus group interviews with 28 community health workers using open-ended questions to explore their perceptions. Analysis of the focus group data revealed that community health workers expressed reluctance to become involved in cases of violence against women. The reasons they provided are grouped under three main themes: barriers to identification; barriers to assessment; and barriers to intervention. Training programs offered to rural community health workers need to be aware of the barriers to identifying, assessing and intervening in cases of violence against women that are highlighted by this study. Further studies are needed to assess the wider relevance of these findings to other groups of community health workers in rural and non-rural settings.