A prospective pilot study evaluating the ‘cardiac decompensation score’ in the setting of intraaortic balloon counterpulsation

The study objective was to determine whether the ‘cardiac decompensation score’ could identify cardiac decompensation in a patient with existing cardiac compromise managed with intraaortic balloon counterpulsation (IABP). A one-group, posttest-only design was utilised to collect observations in 2003 from IABP recipients treated in the intensive care unit of a 450 bed Australian, government funded, public, cardiothoracic, tertiary referral hospital. Twenty-three consecutive IABP recipients were enrolled, four of whom died in ICU (17.4%). All non-survivors exhibited primarily rising scores over the observation period (p < 0.001) and had final scores of 25 or higher. In contrast, the maximum score obtained by a survivor at any time was 15. Regardless of survival, scores for the 23 participants were generally decreasing immediately following therapy escalation (p = 0.016). Further reflecting these changes in patient support, there was also a trend for scores to move from rising to falling at such treatment escalations (p = 0.024). This pilot study indicates the ‘cardiac decompensation score’ to accurately represent changes in heart function specific to an individual patient. Use of the score in conjunction with IABP may lead to earlier identification of changes occurring in a patient's cardiac function and thus facilitate improved IABP outcomes.

Prospective bus rapid transit scenarios for pilot corridor in Dhaka

Dhaka doesn’t have a mature transport system. Lacking in institutional arrangements, policy and planning, and law enforcement, the transport system operates has developed ad hoc and is situationally problematic. Absence of proper coordination between modes, poor public transport system, inadequate pedestrian facilities, and environmental degradation justify full consideration of Bus Rapid Transit (BRT) in Dhaka. BRT centres on sustainable transport principles. BRT is a system, which is capable to mitigate Dhaka’s transport problem if properly planned. In Strategic transport plan of Dhaka three BRT transport corridor has been proposed and BRT pre-feasibility study came up with one pilot corridor for early implementation of BRT. This paper first reviews international best practices then explores various BRT system packages and evaluates the suitability of these BRT packages by analyzing current bus service condition and physical and geometric configuration along the BRT pilot corridor. It concludes by proposing some BRT scenarios, which can be considered for further evaluation with respect to speed, delay, travel time and environmental pollution.

Defending the patch : a labour geography analysis of unions’ construction of and responses to the problem of declining union membership amongst youth

If the trade union movement is to remain an influential force in the industrial, economic and socio/political arenas of industrialised nations it is vital that its recruitment of young members improve dramatically. Australian union membership levels have declined markedly over the last three decades and youth union membership levels have decreased more than any age group. Currently around 10% of young workers aged between 16-24 years are members of unions in Australia compared to 26% of workers aged 45-58 (Oliver, 2008). This decline has occurred throughout the union movement, in all states and in almost all industries and occupations. This research, which consists of interviews with union organisers and union officials, draws on perspectives from the labour geography literature to explore how union personnel located in various places, spaces and scales construct the issue of declining youth union membership. It explores the scale of connections within the labour movement and the extent to which these connections are leveraged to address the problem of youth union membership decline. To offer the reader a sense of context and perspective, the thesis firstly outlines the historical development of the union movement. It also reviews the literature on youth membership decline. Labour geography offers a rich and apposite analytical tool for investigation of this area. The notion of ‘scale’ as a dynamic, interactive, constructed and reconstructed entity (Ellem, 2006) is an appropriate lens for viewing youth-union membership issues. In this non-linear view, scale is a relational element which interplays with space, place and the environment (Howett, in Marston, 2000) rather than being ‘sequential’ and hierarchical. Importantly, the thesis investigates the notion of unions as ‘spaces of dependence’ (Cox, 1998a, p.2), organisations whose space is centred upon realising essential interests. It also considers the quality of unions’ interactions with others – their ‘spaces of engagement‘(Cox, 1998a, p.2), and the impact that this has upon their ability to recruit youth. The findings reveal that most respondents across the spectrum of the union movement attribute the decline in youth membership levels to factors external to the movement itself, such as changes to industrial relations legislation and the impact of globalisation on employment markets. However, participants also attribute responsibility for declining membership levels to the union movement itself, citing factors such as a lack of resourcing and a need to change unions’ perceived identity and methods of operation. The research further determined that networks of connections across the union movement are tenuous and, to date, are not being fully utilised to assist unions to overcome the youth recruitment dilemma. The study concludes that potential connections between unions are hampered by poor resourcing, workload issues and some deeply entrenched attitudes related to unions ‘defending (and maintaining) their patch’.

The nature of caregiving in children of a parent with multiple sclerosis from multiple sources and the associations between caregiving activities and youth adjustment overtime

This study explored youth caregiving for a parent with multiple sclerosis (MS) from multiple perspectives, and examined associations between caregiving and child negative (behavioural emotional difficulties, somatisation) and positive (life satisfaction, positive affect, prosocial behaviour) adjustment outcomes overtime. A total of 88 families participated; 85 parents with MS, 55 partners and 130 children completed questionnaires at Time 1. Child caregiving was assessed by the Youth Activities of Caregiving Scale (YACS). Child and parent questionnaire data were collected at Time 1 and child data were collected 12 months later (Time 2). Factor analysis of the child and parent YACS data replicated the four factors (instrumental, social-emotional, personal-intimate, domestic-household care), all of which were psychometrically sound. The YACS factors were related to parental illness and caregiving context variables that reflected increased caregiving demands. The Time 1 instrumental and social-emotional care domains were associated with poorer Time 2 adjustment, whereas personal-intimate was related to better adjustment and domestic-household care was unrelated to adjustment. Children and their parents exhibited highest agreement on personal-intimate, instrumental and total caregiving, and least on domestic-household and social-emotional care. Findings delineate the key dimensions of young caregiving in MS and the differential links between caregiving activities and youth adjustment.

Punitiveness and the criminalisation of the other : State wards, unlawful non-citizens and Indigenous youth

This paper explores the genealogies of bio-power that cut across punitive state interventions aimed at regulating or normalising several distinctive ‘problem’ or ‘suspect’ deviant populations, such as state wards, non-lawful citizens and Indigenous youth. It begins by making some general comments about the theoretical approach to bio-power taken in this paper. It then outlines the distinctive features of bio-power in Australia and how these intersected with the emergence of penal welfarism to govern the unruly, unchaste, unlawful, and the primitive. The paper draws on three examples to illustrate the argument – the gargantuan criminalisation rates of Aboriginal youth, the history of incarcerating state wards in state institutions, and the mandatory detention of unlawful non-citizens and their children. The construction of Indigenous people as a dangerous presence, alongside the construction of the unruly neglected children of the colony — the larrikin descendants of convicts as necessitating special regimes of internal controls and institutions, found a counterpart in the racial and other exclusionary criteria operating through immigration controls for much of the twentieth century. In each case the problem child or population was expelled from the social body through forms of bio-power, rationalised as strengthening, protecting or purifying the Australian population.

Expected values for pedometer-determined physical activity in youth

This review assembles pedometry literature focused on youth, with particular attention to expected values for habitual, school day, physical education class, recess, lunch break, out-of-school, weekend, and vacation activity. From 31 studies published since 1999, we constructed a youth habitual activity step-curve that indicates: (a) from ages 6 to 18 years, boys typically take more steps per day than girls; (b) for both sexes the youngest age groups appear to take fewer steps per day than those immediately older; and (c) from a young age, boys decline more in steps per day to become move consistent with girls at older ages. Additional studies revealed that boys take approximately 42-49% of daily steps during the school day; girls take 41-47%. Steps taken during physical education class contribute to total steps per day by 8.7-23.7% in boys and 11.4-17.2% in girls. Recess represents 8-11% and lunch break represents 15-16% of total steps per day. After-school activity contributes approximately 47-56% of total steps per day for boys and 47-59% for girls. Weekdays range from approximately 12,000 to 16,000 steps per day in boys and 10,000 to 14,000 steps per day in girls. The corresponding values for weekend days are 12,000-13,000 steps per day in boys and 10,000-12,000 steps per day in girls.

Pedometry methods for assessing free-living youth

The purpose of this review is to integrate and summarize specific measurement topics (instrument and metric choice, validity, reliability, how many and what types of days, reactivity, and data treatment) appropriate to the study of youth physical activity. Research quality pedometers are necessary to aid interpretation of steps per day collected in a range of young populations under a variety of circumstances. Steps per day is the most appropriate metric choice, but steps per minute can be used to interpret time-in-intensity in specifically delimited time periods (e.g., physical education class). Reported intraclass correlations (ICC) have ranged from .65 over 2 days (although higher values also have been reported for 2 days) to .87 over 8 days (although higher values have been reported for fewer days). Reported ICCs are lower on weekend days (.59) versus weekdays (.75) and lower over vacation days (.69) versus school days (.74). There is no objective evidence of reactivity at this time. Data treatment includes (a) identifying and addressing missing values, (b) identifying outliers and reducing data appropriately if necessary, and (c) transforming the data as required in preparation for inferential analysis. As more pedometry studies in young populations are published, these preliminary methodological recommendations should be modified and refined.

Response to "a step in the right direction : commentary on expected values for pedometer-determined physical activity in youth"

The figure Beets took exception to displays sex‐ and age‐specific median values of aggregated published expected values for pedometer determined physical activity.

The development of the extended adolescent injury checklist (E-AIC) : a measure for injury prevention program evaluation

The Extended Adolescent Injury Checklist (E-AIC), a self-report measure of injury based on the model of the Adolescent Injury Checklist (AIC), was developed for use in the evaluation of school-based interventions. The three stages of this development involved focus groups with adolescents and consultations with medical staff, pilot testing of the revised AIC in a high school context, and use of the finalised checklist in pre- and post-questionnaires to examine its utility. Results revealed that responses to the final version of the E-AIC were meaningful and remained consistent over time. The E-AIC appears to be a promising measure of adolescent injury that is simple, time-efficient and appropriate for use in the evaluation of school-based injury prevention programs.

Development of a workplace wellness promotion pilot framework : a case study of the Blue Care Staff Wellness Program

Workplace wellness initiatives are currently unreflective of the multidimensional and holistic nature of the wellness construct. There exists an opportunity for promoters of health to move toward models of workplace wellness promotion that more fully appreciate the interconnected nature of health dimensions and promote them even-handedly. The Blue Care Staff Wellness Program framework was developed in response to a recognised need for consistent and wellness-focused constructs for workplace wellness promotion and dissemination. The framework promotes and supports the individual and organisational wellness of the Blue Care employee population by providing a comprehensive and sustainable employee wellness program. This has been achieved by the adoption of consistent wellness principles to guide the framework conception and theory based development. The use of the framework in a pilot program will provide insight into the frameworks effectiveness in promoting a comprehensive workplace wellness program, and go further to establish the relationship between wellness and productivity in the workplace.