A cross-sectional analysis of patterns of obesity in a cohort of working nurses and midwives in Australia, New Zealand, and the United Kingdom

Objective The aim of this study was to examine the prevalence of overweight and obesity and the association with demographic, reproductive work variables in a representative cohort of working nurses and midwives. Design A cross sectional study of self reported survey data. Settings Australia, New Zealand and the United Kingdom. Methods Measurement outcomes included BMI categories, demographic (age, gender, marital status, ethnicity), reproductive (parity, number of births, mother's age at first birth, birth type and menopausal status) and workforce (registration council, employment type and principal specialty) variables. Participants 4996 respondents to the Nurses and Midwives e-Cohort study who were currently registered and working in nursing or midwifery in Australia (n=3144), New Zealand (n=778) or the United Kingdom (n=1074). Results Amongst the sample 61.87% were outside the healthy weight range and across all three jurisdictions the prevalence of obesity in nurses and midwives exceeded rates in the source populations by 1.73% up to 3.74%. Being overweight or obese was significantly associated with increasing age (35–44 yrs aOR 1.71, 95% CI 1.41–2.08; 45–55 yrs aOR 1.90, 95%CI 1.56–2.31; 55–64 aOR 2.22, 95% CI 1.71–2.88), and male gender (aOR 1.46, 95% CI 1.15–1.87). Primiparous nurses and midwives were more likely to be overweight or obese (aOR 1.37, 95% CI 1.06–1.76) as were those who had reached menopause (aOR 1.37, 95% CI 1.11–1.69). Nurses and midwives in part-time or casual employment had significantly reduced risk of being overweight or obese, (aOR 0.81, 95% CI 0.70–0.94 and aOR 0.75, 95% CI 0.59–0.96 respectively), whilst working in aged carried increased risk (aOR 1.37, 95% CI 1.04–1.80). Conclusion Nurses and midwives in this study have higher prevalence of obesity and overweight than the general population and those who are older, male, or female primiparous and menopausal have significantly higher risk of overweight or obesity as do those working fulltime, or in aged care. The consequences of overweight and obesity in this occupational group may impact on their workforce participation, their management of overweight and obese patients in their care as well as influencing their individual health behaviours and risks of occupational injury and chronic disease.

What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study

This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems.

Modelling surface and shallow groundwater interactions in an ungauged subtropical coastal catchment using the SWAT model, Elimbah Creek, southeast Queensland, Australia

The study presented here applies the highly parameterised semi-distributed U.S. Department of Agriculture Soil and Water Assessment Tool (SWAT) to an Australian subtropical catchment. SWAT has been applied to numerous catchments worldwide and is considered to be a useful tool that is under ongoing development with contributions coming from different research groups in different parts of the world. In a preliminary run the SWAT model application for the Elimbah Creek catchment has estimated water yield for the catchment and has quantified the different sources. For the modelling period of April 1999 to September 2009 the results show that the main sources of water in Elimbah Creek are total surface runoff and lateral flow (65%). Base-flow contributes 36% to the total runoff. On a seasonal basis modelling results show a shift in the source of water contributing to Elimbah Creek from surface runoff and lateral flow during intense summer storms to base-flow conditions during dry months. Further calibration and validation of these results will confirm that SWAT provides an alternative to Australian water balance models.

Aerosol mass spectrometric analysis of the chemical composition of non- refractory PM1 samples from school environments in Brisbane, Australia

Long term exposure to vehicle emissions has been associated with harmful health effects. Children are amongst the most susceptible group and schools represent an environment where they can experience significant exposure to vehicle emissions. However, there are limited studies on children’s exposure to vehicle emissions in schools. The aim of this study was to quantify the concentration of organic aerosol and in particular, vehicle emissions that children are exposed to during school hours. Therefore an Aerodyne compact time-of-flight aerosol mass spectrometer (TOF-AMS) was deployed at five urban schools in Brisbane, Australia. The TOF-AMS enabled the chemical composition of the non- refractory (NR-PM1) to be analysed with a high temporal resolution to assess the concentration of vehicle emissions and other organic aerosols during school hours. At each school the organic fraction comprised the majority of NR-PM1 with secondary organic aerosols as the main constitute. At two of the schools, a significant source of the organic aerosol (OA) was slightly aged vehicle emissions from nearby highways. More aged and oxidised OA was observed at the other three schools, which also recorded strong biomass burning influences. Primary emissions were found to dominate the OA at only one school which had an O:C ratio of 0.17, due to fuel powered gardening equipment used near the TOF-AMS. The diurnal cycle of OA concentration varied between schools and was found to be at a minimum during school hours. The major organic component that school children were exposed to during school hours was secondary OA. Peak exposure of school children to HOA occurred during school drop off and pick up times. Unless a school is located near major roads, children are exposed predominately to regional secondary OA as opposed to local emissions during schools hours in urban environments.

An evidence-informed strategy to prevent osteoporosis in Australia

Osteoporosis imposes a tremendous burden on Australia : 1.2 million Australians have osteoporosis and 6.3 million have Osteopenia. In the 2007-08 financial year, 82000 Australians suffered fragility fractures, of Which >17000 were hip fractures. In the 2000-01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolescence to prevent premature bone loss and improve or maintain muscle mass, strength and functional capacity in healthy adults to prevent and treat osteoporosis in order to minimise the risk of suffering fragility fractures, and reduce falls risk, in older people. The recommendations focus on three affordable and important interventions to ensure people have adequate calcium intake, vitamin D levels and appropriate, physical activity throughout their lives. Recommendations relevant to all stages of life include: daily dietary calcium intakes should be consistent with Australian and New Zealand guidelines serum levels of vitamin D in the general population should be above 50 nmol/L in winter or early spring for optimal bone health regular weight-bearing physical activity, Muscle strengthening exercises and challenging balance/ mobility activities should be conducted in a safe environment.

Environmental rating tools and residential land development in Australia

EnviroDevelopment National Board of Management board member, Lyndall Bryant, has recently conducted research into environmental rating tools and how their environmental benefits within residential land developments can be quantified.

Why are children the most important audience for pornography in Australia?

Who watches pornography in Australia? If you listen to public debates about the genre the answer is clear – it’s children. Children are accessing pornography on smartphones (Murray and Tin 2011). Children are taking ‘lewd’ photographs of themselves, creating their own pornography (Nelligan and Etheridge 2011). Indigenous Australian children must be protected by banning pornography (the Age 2011). Pornographic magazines are placed where children can see them (O'Rourke 2011). Exposure to pornography is damaging children (Sundstrom 2011). The Australian Government insists that the Internet must be filtered to protect children from pornography (Collerton 2010). And if indeed any adults are watching pornography in Australia, then it’s child pornography (MacDonald 2011; Ralston and Howden 2011).In story after story, public debate about pornography focuses on children as its audience. There is no suggestion that children are numerically the largest audience of pornography in Australia. But emphatically the suggestion is that children are the most important audience to be taken into account when thinking about the genre. This chapter explores why this is the case, and notes the political advantages and disadvantages of focusing on children as the most important audience for pornography in Australia.

Nutritional analysis of gastric contents and body condition score at a single time point in feral horses in Australia

Objective: To determine the impact of a free-choice diet on nutritional intake and body condition of feral horses. Animals: Cadavers of 41 feral horses from 5 Australian locations. Procedures: Body condition score (BCS) was determined (scale of 1 to 9), and the stomach was removed from horses during postmortem examination. Stomach contents were analyzed for nutritional variables and macroelement and microelement concentrations. Data were compared among the locations and also compared with recommended daily intakes for horses. Results: Mean BCS varied by location; all horses were judged to be moderately thin. The BCS for males was 1 to 3 points higher than that of females. Amount of protein in the stomach contents varied from 4.3% to 14.9% and was significantly associated with BCS. Amounts of water-soluble carbohydrate and ethanol-soluble carbohydrate in stomach contents of feral horses from all 5 locations were higher than those expected for horses eating high-quality forage. Some macroelement and microelement concentrations were grossly excessive, whereas others were grossly deficient. There was no evidence of ill health among the horses. Conclusions and Clinical Relevance: Results suggested that the diet for several populations of feral horses in Australia appeared less than optimal. However, neither low BCS nor trace mineral deficiency appeared to affect survival of the horses. Additional studies on food sources in these regions, including analysis of water-soluble carbohydrate, ethanol-soluble carbohydrate, and mineral concentrations, are warranted to determine the provenance of such rich sources of nutrients. Determination of the optimal diet for horses may need revision.

Distances travelled by feral horses in ‘outback’ Australia

Reasons for performing study: The distance travelled by Australian feral horses in an unrestricted environment has not previously been determined. It is important to investigate horse movement in wilderness environments to establish baseline data against which the movement of domestically managed horses and wild equids can be compared. Objectives: To determine the travel dynamics of 2 groups of feral horses in unrestricted but different wilderness environments. Methods: Twelve feral horses living in 2 wilderness environments (2000 vs. 20,000 km2) in outback Australia were tracked for 6.5 consecutive days using custom designed, collar mounted global positioning systems (GPS). Collars were attached after darting and immobilising the horses. The collars were recovered after a minimum of 6.5 days by re-darting the horses. Average daily distance travelled was calculated. Range use and watering patterns of horses were analysed by viewing GPS tracks overlaid on satellite photographs of the study area. Results: Average distance travelled was 15.9 ± 1.9 km/day (range 8.1–28.3 km/day). Horses were recorded up to 55 km from their watering points and some horses walked for 12 h to water from feeding grounds. Mean watering frequency was 2.67 days (range 1–4 days). Central Australian horses watered less frequently and showed a different range use compared to horses from central Queensland. Central Australian horses walked for long distances in direct lines to patchy food sources whereas central Queensland horses were able to graze close to water sources and moved in a more or less circular pattern around the central water source. Conclusions: The distances travelled by feral horses were far greater than those previously observed for managed domestic horses and other species of equid. Feral horses are able to travel long distances and withstand long periods without water, allowing them to survive in semi-arid conditions.

Australia's disabling income support system : tracing the history of the Australian disability income support system 1908 to 2007 : disablism, citizenship and the basic income proposal

The present study examined the historical basis of the Australian disability income support system from 1908 to 2007. Although designed as a safety net for people with a disability, the disability income support system within Australia has been highly targeted. The original eligibility criteria of "permanently incapacitated for work", medical criteria and later "partially capacitated for work" potentially contained ideological inferences that permeated across the time period. This represents an important area for study given the potential consequence for disability income support to marginalise people with a disability. Social policy and disability policy theorists, including Saunders (2007, Social Policy Research Centre [SPRC]) and Gibilisco (2003) have provided valuable insight into some of the effects of disability policy and poverty. Yet while these theorists argued for some form of income support they did not propose a specific form of income security for further exploration. Few studies have undertaken a comprehensive review of the history of disability income support within the Australian context. This thesis sought to redress these gaps by examining disability income support policy within Australia. The research design consisted of an in-depth critical historical-comparative policy analysis methodology. The use of critical historical-comparative policy analysis allowed the researcher to trace the construction of disability within the Australian disability income support policy across four major historical epochs. A framework was developed specifically to guide analysis of the data. The critical discourse analysis method helped to understand the underlying ideological dimensions that led to the predominance of one particular approach over another. Given this, the research purpose of the study centred on: i. Tracing the history of the Australian disability income support system. ii. Examining the historical patterns and ideological assumptions over time. iii. Exploring the historical patterns and ideological assumptions underpinning an alternative model (Basic Income) and the extent to which each model promotes the social citizenship of people with a disability. The research commitment to a social-relational ontology and the quest for social change centred on the idea that "there has to be a better way" in the provision of disability income support. This theme of searching for an alternative reality in disability income support policy resonated throughout the thesis. This thesis found that the Australian disability income support system is disabling in nature and generates categories of disability on the basis of ableness. From the study, ableness became a condition for citizenship. This study acknowledged that, in reality, income support provision reflects only one aspect of the disabling nature of society which requires redressing. Although there are inherent tensions in any redistributive strategy, the Basic Income model potentially provides an alternative to the Australian disability income support system, given its grounding in social citizenship. The thesis findings have implications for academics, policy-makers and practitioners in terms of developing better ways to understand disability constructs in disability income support policy. The thesis also makes a contribution in terms of promoting income support policies based on the rights of all people, not just a few.

Surgical site infection prevention following total hip arthroplasty in Australia : a cost-effectiveness analysis

Background: Surgical site infection (SSI) is associated with substantial costs for health services, reduced quality of life, and functional outcomes. The aim of this study was to evaluate the cost-effectiveness of strategies claiming to reduce the risk of SSI in hip arthroplasty in Australia. Methods: Baseline use of antibiotic prophylaxis (AP) was compared with no antibiotic prophylaxis (no AP), antibiotic-impregnated cement (AP þ ABC), and laminar air operating rooms (AP þ LOR). A Markov model was used to simulate long-term health and cost outcomes of a hypothetical cohort of 30,000 total hip arthroplasty patients from a health services perspective. Model parameters were informed by the best available evidence. Uncertainty was explored in probabilistic sensitivity and scenario analyses. Results: Stopping the routine use of AP resulted in over Australian dollars (AUD) $1.5 million extra costs and a loss of 163 quality-adjusted life years (QALYs). Using antibiotic cement in addition to AP (AP þ ABC)generated an extra 32 QALYs while saving over AUD $123,000. The use of laminar air operating rooms combined with routine AP (AP þ LOR) resulted in an AUD $4.59 million cost increase and 127 QALYs lost compared with the baseline comparator. Conclusion: Preventing deep SSI with antibiotic prophylaxis and antibiotic-impregnated cement has shown to improve health outcomes among hospitalized patients, save lives, and enhance resource allocation. Based on this evidence, the use of laminar air operating rooms is not recommended.

Sustainable infrastructure procurement in Australia : standard vs. project practices

The Australian Government and most Australian road authorities have set ambitious greenhouse gas emission (GHGe) reduction targets for the near future, many of which have translated into action plans. However, previous research has shown that the various Australian state road authorities are at different stages of implementing ‘green’ initiatives in construction planning and development, with considerable gaps in their monitoring, tendering, and contracting. This study illustrates the differences between procurement standards and project specific practices that aim to reduce GHGe from road construction projects in three of the largest Australian road construction clients, with a focus on the tools used, contract type and incentives for better performance.

Working for a better life : longitudinal evidence on the predictors of employment among recently arrived refugee migrant men living in Australia

Although a number of studies have investigated the predictors of employment among refugee migrants, there is a dearth of evidence from longitudinal data. This study investigated the cross-sectional and longitudinal predictors of employment among 233 adult refugee men living in South-East Queensland, Australia. Participants were interviewed four times at six-month intervals between 2008 and 2010. Using a conceptual model developed from the literature, Generalised Estimating Equations were used to model the predictors of employment. Over time, the employment rate increased from 44 percent to 56 percent. Region of birth, length of time in Australia, seeking employment through job service providers and informal networks, and owning a car were significant predictors of employment. Contrary to previous research, English language proficiency was not a significant predictor when other variables were controlled for. Recognition of overseas skills and qualifications decreased the chances of finding employment. The policy and program implications are discussed.

The gender wage gap: what has happened between 1973 and 1990 in Australia?

The current study examines the change in the gender wage gap in Australia over the period 1973 to 1990. The Juhn, Murphy and Pierce (1991) decomposition is used in order to evaluate the role and relative contribution of changes in observed and unobserved skills and their prices. The sensitivity of conclusions to the measure of labour market experience and industry and occupation structure are also examined. The analysis concludes that gender-specific effects are dominant in male-female wage convergence although wage-structure effects also play a minor role.

Green office interiors in Australia : lessons learnt

In 2003, the Green Building Council of Australia (GBCA) launched their Green Star rating tools for various types of buildings in order to promote green building practice in Australia. Of these, the Green Star-Office Interior rating tool is designed for building owners, tenants and interior designers to assess the environmental impact of an interior fitout. It covers a number of categories, including Management, Indoor Environment Quality, Energy, Transport, Water, Materials, Land Use and Ecology, Emissions, and Innovation. This paper reviews the usage of the Green Star system in Australian office tenancy fitouts and the potential challenges associated with Green Star-Office Interior implementation. This involves the analysis of score sheets of 66 office interior projects across Australia that achieved Green Star certification. The percentage of green star points obtained within each category and sub-categories (credits) for each project are investigated to illustrate the achievement of credits. The results show that Emission-related credits and Innovation related credits are the easiest and most difficult respectively to obtain. It is also found that 6 Green Star office interior projects perform especially better in the categories of Energy and Ecology than 4 and 5 Star projects. The investigation of point frequency in each category provides prospective Green Star applicants with insights into credit achievement for future projects.