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There is currently a void in the literature regarding the kinds of support women find most beneficial when dealing with a spouse’s sexually addictive or compulsive behaviors. Addressing this void is particularly relevant for clergy, seeing as they are increasingly sought out as an initial and/or primary support for dealing with this marital issue. Using grounded theory methodology, 22 women from Canada and the USA were interviewed to find out what they found most helpful as they sought support to cope with a spouse’s sexually addictive and compulsive behaviors. Insights for pastoral counselors and clergy were highlighted.

Objective: To examine the association between energy cost and energy density of fast food products. Methods: Twenty Sydney outlets of the five largest fast food chains were surveyed four times. Price and kilojoule data were collected for all limited-time-only menu items (n=54) and a sample of standard items (n=67). Energy cost ($/kilojoule) and energy density (kilojoules/gram) of menu items were calculated. Results: There was a significant inverse relationship between menu item energy density and energy cost (p

This study examined the serving size and energy content per serving of Australian packaged snack foods and confectionery products. Nutrition Information Panel data for 23 sub-categories of packaged snack foods (n = 3481) were extracted from The George Institute for Global Health's 2013 branded food composition database. Variations in serving size and energy content per serving were examined. Energy contents per serving were compared to recommendations in the Australian Dietary Guidelines. Serving sizes varied within and between snack food categories. Mean energy content per serving varied from 320 kJ to 899 kJ. More energy per serving than the recommended 600 kJ was displayed by 22% (n = 539) of snack foods classified in the Australian Dietary Guidelines as discretionary foods. The recommendation for energy content per serving was exceeded in 60% (n = 635) of snack foods from the Five Food Groups. Only 37% (n = 377) of confectionery products displayed the industry-agreed serving size of 25 g. Energy content per serving of many packaged snack foods do not align with the Australian Dietary Guidelines and the industry agreed serving size has not been taken up widely within the confectionery category. Given the inconsistencies in serving sizes, featuring serving size in front-of-pack information may hinder the objective of a clear and simple nutrition message. Messaging to help consumers make healthier choices should consider the variation in serving sizes on packaged snack foods.

DThis study was designed to gain a greaterunderstanding of the effects cancer has onfamilies while simultaneously developingfamily therapy interventions that are help-ful for families experiencing the crucible ofcancer. On the basis of an action researchparadigm, the authors designed an inten-sive case-analysis protocol involving resec-tive interviewing to learn about the per-sonal perspectives of family members whoparticipate in therapeutic treatment forcancer. An integration of resective insightby the families, their therapist, and the re-search team ultimately revealed that cancerfamilies face an ongoing struggle (a) be-tween feelings of isolation and connected-ness, (b) to make meaning of cancer in theirlife, and (c) to Þnd ways of incorporatingcancer into their current world view. Thestudy also revealed shared experiencebuilding and interactive psychoeducationto be the most signiÞcant components of thetherapeutic treatment process for cancerfamilies.

The 32-item Attitudes About Romance and Mate Selection Scale (ARMSS) was developed to measure constraining beliefs about mate selection. Using factor analysis, seven factors were identified roughly corresponding to Larson's (1992) constraining beliefs about mate selection. The final instrument consisted of four distractor items to help disguise the nature of the instrument plus 28 items on seven subscales: (a) One and Only, (b) Love Is Enough, (c) Cohabitation, (d) Complete Assurance, (e) Idealization, (f) Ease of Effort, and (g) Opposites Complement. Reliability and validity evidence was demonstrated. Results showed few gender differences in the degree to which constraining beliefs about mate selection are held by single young adults. However, significant differences were found when age, religious affiliation, and ethnicity were considered. Implications for using the ARMSS in premarital counseling and education are discussed. Key Words: attitudes, beliefs, marriage, male selection, premarital counseling. The process of choosing a mate is a significant and often difficult one for many single adults. Few other choices may become as strong an epicenter for consequences that ripple out across the lifespan of the couple and of the marriage. Unfortunately, as Lederer and Jackson (1968) argued, in the height of courtship young adults often become reckless and either ignore the problems inherent in marriage or do not consider them. In addition, certain attitudes and beliefs promulgated in American society contribute to frustration and dissatisfaction in the mate selection process (Crosby, 1985). Among these beliefs are constraining beliefs about mate selection (Larson, 1992). Constraining beliefs about mate selection are defined as personal beliefs that may (a) limit one's choices regarding who or when one marries, (b) encourage exaggerated or minimal personal effort to find a suitable mate, (c) inhibit thoughtful consideration of interpersonal strengths and weaknesses and of premarital factors known to have an influence on the success of marriage, and/or (d) perpetuate mate selection problems and frustration and restrict options for alternative solutions for problems (Larson, 2000; Larson & Holman, 1994). For example, premarital couples may believe that their love, sufficient to overcome all difficulties, should naturally lead to marriage (McGinnis, 1990; Larson, 1992), even though many authors have criticized the notion of romantic love as a sole justification for marriage (e.g., Crosby, 1985; Larson, 2000). A belief in a "one and only" soul mate may encourage a search, not for a good companion (one of several right choices), but for the one right companion; such a search may invite passive waiting and possible blindness to compatible candidates (Larson, 1992; Lazarus, 1985). Still other spouse seekers set their standards so high that their criteria are almost impossible to fulfill or so low that they invite poor marriage prospects (Larson, 1992, 2000). Little is known about the degree to which young, single adults endorse such constraining beliefs or about the degree to which some beliefs are favored over others. The importance of studying beliefs in relationships is underscored by the volume of literature suggesting that beliefs are intertwined with behaviors and feelings (e.g., Baucom, Epstein, & Rankin, 1995; Bradbury & Fincham, 1992; Wright, Watson, & Bell, 1996). Our beliefs influence the way we feel and guide our responses to situations, which, in turn, influences the degree of satisfaction we feel with our lives and relationships. For example, those who believe, "I must be totally perfect before I get married," may feel so inadequate and discouraged about their weaknesses that they avoid searching constructively for a mate. Understanding the prevalence of constraining beliefs about mate selection among single men and women, as well as which beliefs may be particularly problematic, can assist therapists, premarital counselors, and marriage educators to help individuals better prepare for marriage. …

Objectives: 1) Explore the availability and accessibility of fast food energy and nutrient information post-NSW menu labelling legislation in states with and without menu labelling legislation. 2) Determine whether availability and accessibility differed compared with pre-menu labelling legislation in NSW. Methods: We visited 210 outlets of the five largest fast food chains in five Australian states to observe the availability and accessibility of energy and nutrient information. Results were compared with 197 outlets surveyed pre-menu labelling. Results: Most outlets (95%) provided energy values, half provided nutrient values and 3% provided information for all menu items. The total amount of information available increased post-NSW menu labelling implementation (473 versus 178 pre-implementation, p

Bunk beds have long been recognised as a potential source of injury to children. This study was undertaken to establish an evidence base for a proposed injury reduction program and to determine whether or not there is a case for a mandatory safety standard. Recent literature on bunk bed safety was reviewed to provide an overview of the injury issues involved. Major sources of relevant Australian and international data were identified and the available data summarised. An in-depth analysis of Victorian data was undertaken to identify the nature and severity of injuries sustained and any patterns or trends, including age profiles. It is estimated that, in Australia, in the under fifteen age-group, there are at least 2,100 bunk bed-related injuries treated annually by hospital emergency departments. This represents a rate of about 50 injuries per 100,000 age-specific population. The majority of these injuries (86%) occur in children under the age of 10 years with injuries peaking in the 5-9 year age-group. T...

In this multiply-authored account, five academicians discuss the connections between their work as clinicians and their clinical qualitative research. Each saw connections between practice and research, and each in her or his own domain of interest has found that practice informs research and research informs practice. This article also introduces three major types of qualitative clinical family research: conversational analysis, recursive frame analysis, and hermeneutic phenomenology.

This research was carried out on behalf of the Australia National Audit Office to obtain an estimate of the direct hospital and medical treatment costs of consumer product-related injury in Austral...

The beliefs held by nurses have the potential to influence the beliefs of the individuals andfamiliesfor whom they care. This clinical example presents the experience of a couple who presented with marital conflict at the Family Nursing Unit, University of Calgary, about 8 months following the husband's second myocardial infarction. As the story of this couple's recovery experience unfolded, the constraining influence of the hospital nurses' beliefs on the wife's behavior throughout her husband's recovery became evident. The iatrogenically induced beliefs constrained the wife from voicing her concerns directly to her husband because she believed she could increase her husband's stress and make him ill. A clinical model offamily systems nursing that focuses on beliefs guided the assessment and intervention offered to the couple. Ironically, this clinical case example describes how one group of nurses assisted the family by challenging the beliefs of another group of nurses. The importance and influence of beliefs, particularly the beliefs of nurses, are highlighted.

ObjectiveTo investigate nutrition literacy among adult grocery buyers regarding energy-related labelling terms on food packaging.DesignQualitative interviews and quantitative surveys to determine shoppers’ understanding of energy terms (‘energy’, ‘calories’ and ‘kilojoules’) and how energy terms affect perceptions of healthiness and intentions to purchase breakfast cereals, muesli bars and frozen meals.SettingIndividual in-depth interviews and surveys in two metropolitan supermarkets, Sydney, Australia.SubjectsAustralian adults (interview n 40, survey n 405) aged 18–79 years.ResultsThe relationship between energy and perceived healthiness of food varied by product type: higher energy breakfast cereals were perceived to be healthier, while lower energy frozen meals were seen as healthier choices. Likewise, intentions to purchase the higher energy product varied according to product type. The primary reason stated for purchasing higher energy products was for sustained energy. Participants from households of lower socio-economic status were significantly more likely to perceive higher energy products as healthier. From the qualitative interviews, participants expressed uncertainty about their understanding of kilojoules, while only 40 % of participants in intercept surveys correctly answered that kilojoules and calories measured the same thing.ConclusionsAustralian consumers have a poor understanding of energy and kilojoules and tend to perceive higher energy products as healthier and providing sustained energy. This has implications regarding the usefulness of industry front-of-pack labelling initiatives and quick service restaurant menu labelling that provides information on energy content only. Comprehensive and widely communicated education campaigns will be essential to guide consumers towards healthier choices.

International audience; BACKGROUND: Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. METHODS: We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or disease-prevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. FINDINGS: 13,902 individuals participated in household surveys and 16,328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0*9 or higher in all surveys except in Bangladesh (r=0*75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0*05. Five (11%) states had weights below 0*01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0*76) and severe multiple sclerosis (0*71). We identified a broad pattern of agreement between the old and new weights (r=0*70), particularly in the moderate-to-severe range. However, in the mild range below 0*2, many states had significantly lower weights in our study than previously. INTERPRETATION: This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results. FUNDING: Bill & Melinda Gates Foundation.

Family violence has often been conceptualized as a linear phenomenon in which perpetrators commit acts intended to hurt victims. Intervention in these circumstances involves treating the perpetrator and the victim individually. In contrast, this article presents a Systemic Belief Approach to the situation of mutual family violence. A case example illustrates the influence of beliefs on the occurrence of violent acts between family members (in this case, sole-parent mother and adolescent daughter). Family systems nursing interventions such as reflective questions and reflecting teams are used to challenge the family's constraining beliefs, which enables the coevolution of facilitative beliefs that invite healing.

Background Falls in older people continue to be a major public health issue in industrialized countries. Extensive research into falls prevention has identified exercise as a proven fall prevention strategy. However, despite over a decade of promoting physical activity, hospitalisation rates due to falls injuries in older people are still increasing. This could be because efforts to increase physical activity amongst older people have been unsuccessful, or the physical activity that older people engage in is insufficient and/or inappropriate. The majority of older people choose walking as their predominant form of exercise. While walking has been shown to lower the risk of many chronic diseases its role in falls prevention remains unclear. This paper outlines the methodology of a study whose aims are to determine: if a home-based walking intervention will reduce the falls rate among healthy but inactive community-dwelling older adults (65 + years) compared to no intervention (usual activity) and; whether such an intervention can improve risk factors for falls, such as balance, strength and reaction time. Methods/Design This study uses a randomised controlled trial design. A total of 484 older people exercising less than 120 minutes per week will be recruited through the community and health care referrals throughout Sydney and neighboring regions. All participants are randomised into either the self-managed walking program group or the health-education waiting list group using a block randomization scheme. Outcome measures include prospective falls and falls injuries, quality of life, and physical activity levels. A subset of participants (n = 194) will also receive physical performance assessments comprising of tests of dynamic balance, strength, reaction time and lower limb functional status. Discussion Certain types of physical activity can reduce the risk of falls. As walking is already the most popular physical activity amongst older people, if walking is shown to reduce falls the public health implications could be enormous. Conversely, if walking does not reduce falls in older people, or even puts older people at greater risk, then health resources targeting falls prevention need to be invested elsewhere. Trial Registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000380099

Objective To investigate consumers' understanding of terms commonly used to provide guidance about frequency and quantity of food consumption. Methods A survey of 405 shoppers explored how frequently consumers thought food labeled with the terms “eat often,” “eat moderately,” “eat occasionally,” “a sometimes food,” and “an extra food” should be eaten. In a separate phase, 30 grocery buyers responded to open-ended questions about their interpretation of these terms. Results Responses indicated significant differences in meaning between the terms. However, the specific interpretation of each term varied considerably across respondents. The qualitative research found the terms to be highly subjective, and there was a high degree of uncertainty about the meaning of the term “an extra food” in particular. Conclusions and Implications Food frequency and descriptive terms currently used do not provide meaningful or consistent nutritional guidance. There is a need for simple, unambiguous terminology.

Aim: To retrospectively evaluate the NSW Management Policy to Reduce Fall Injury Among Older People, 2003–2007. Methods: The process evaluation was conducted by interviewing stakeholders regarding the implementation of the Policy. A document review was also undertaken to identify activities and initiatives undertaken during the implementation process. Results: Key achievements in the implementation of the Policy and significant early events, decisions and contextual factors which acted as barriers to the implementation were identified. Results included the: identification of the need for the prioritisation of evidence-based interventions; application of consistent best practice guidelines for implementing falls prevention strategies in the community; and development of an evaluation and monitoring framework concurrent with the development of policy. Conclusion: Subsequent policy initiatives must be strategically focused and coordinated if future activities are to have a significant impact on the increasing burden of fall-related injury.

Objective: To develop a comprehensive estimate of the burden of fall-related injury among older people in New South Wales. Methods: Fall injuries in 2006/07 were estimated using information from several datasets and the literature. Healthcare costs were calculated using Australia-Refined - Diagnostic-Related Group costs for hospital episodes of care and average costs for Emergency Department presentations, ambulance transport and residential aged care (RAC). Ratios of the cost of inpatient care relative to other health services, derived from the literature, were used to estimate the costs associated with these services. Results: In 2006/07, in NSW, there were almost 143,000 falls, among older people, resulting in injuries requiring medical treatment. The total cost of healthcare associated with these falls was estimated at $558.5 million. Although accounting for only 6% of the NSW population aged 65 years and older, persons in RAC accounted for 15% of the total cost of falls injury and 21% of hospital inpatient costs. Conclusion and implications: This study demonstrates the extremely high economic cost of falls in older persons and highlights the disproportionate impact of falls in RAC. The study underscores the urgent need for significant investment in fall-injury prevention efforts in both the community and RAC settings. Language: en

Following suicide of a loved one the lives of survivors can be plagued with anger, sadness, shame, guilt, health problems, and agonizing questions. This report presents the Systemic Belief approach to assisting survivors. A case example illustrates the influence beliefs have on survivors' lives. Constraining beliefs are challenged and facilitative beliefs are coevolved through the healing impact of family systems nursing interventions such as therapeutic letters, interventive questions, rituals, and reflecting teams.

Injuries represent a significant health burden in Australia. In New South Wales (NSW), no routine follow-up of post-injury health outcomes is conducted. This article describes the development of a protocol and the conduct of a pilot study to collect information on trauma outcomes at 3 months post-injury at two trauma centres. A modified Victorian model of trauma outcomes monitoring was adopted, with potential participants required to 'opt in' to the collection. Fifty-three percent of individuals contacted consented to opt in, with 75% of these completing an interview. The data items collected were able to provide an indicator of the impact of trauma on individuals. This study has highlighted that there are important methodological issues to be addressed in terms of recruitment in establishing long-term trauma outcomes data collections that are representative of the trauma population. Ultimately, information from a long-term trauma outcomes collection could be linked to data collections to conduct research across the injury continuum.

Background To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Methods Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Results Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30)] whereas "financial security" and "because they felt able to" did not achieve significance. Conclusions Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may provide important opportunities for social marketing approaches designed to alleviate the financial and social burden associated with work disability.

Background Appropriate triage of the trauma patient is essential to ensure prompt access to definitive care. Many trauma centres use a “tiered” trauma call protocol with the intention of providing a match between the facility's resources and the needs of the patient. This study describes the incidence and impact of undertriage on the trauma patient in the context of an Australian level 1 trauma centre with a tiered trauma call system. Methods This was a retrospective analysis of prospective data collected through the Trauma Registry. Undertriage was defined as sustaining an injury severity score greater than 15 and receiving a non-optimal response (i.e., trauma standby call or no call). The level of association between outcome measures (such as LOS in ED, time to OT) and the level of trauma call the patient received was assessed using a general linear model, controlling for injury severity and haemodynamic stability. Results Between February 2004 and November 2008, 5233 patients meeting trauma criteria presented to the study hospital. There was an undertriage rate of 42% and overtriage rate of 21%. Patients were more likely to be undertriaged if they were older, self-presented, their cause of injury was assault or their head or chest were their most severely injured body region. Undertriaged patients had a significantly longer LOS in the ED (2 h) than appropriately triaged patients. Conclusion The implementation of a tiered trauma call system resulted in significant undertriage, especially if the patient was older, had been assaulted or had a head/chest injury. Undertriaged patients experienced delay to definitive care. This study has highlighted the importance of compliance with trauma team activation criteria, trauma monitoring and evaluation.

Low Self-Esteem and Marital Identity

The Assessment of Quality of Life (AQoL) is a generic health-related quality of life (HRQL) measure. It is the only HRQL instrument, currently available, that incorporates health preference values derived from an Australian population and has been extensively trialled in over 40 studies. However, prior to this study, it had not been used to measure HRQL in injury patients. The aim of this study was to evaluate the AQoL, as a measure of the impact of injury on HRQL, by examining its correlation with other commonly used measures of health outcome and its ability to discriminate between groups with injuries of varying type and severity. A total of 221 admitted injury patients, aged 18-74 years, were recruited into the study from four major Victorian metropolitan hospitals and followed up over 12 months. The AQoL and the SF-36 were administered to obtain retrospective measures of pre-injury HRQL and health status with post-injury measurements obtained at five intervals post-injury (to 12 months). A preliminary analysis of data from this study showed the AQoL was positively related to other common outcome measures and, overall, showed a strong correlation with the SF-36 Physical Component Summary and a moderate correlation with the Mental Component Summary. It also demonstrated good discrimination between groups on the basis of type of injury, body region injured and severity of injury. While further testing of the AQoL, in this context, is still necessary, this study suggests that the AQoL may be a useful measure of the impact of injury on HRQL.

This study aimed to develop an estimate of the incidence of all medically-treated injury by level of severity and to broadly describe the epidemiology of injury in the Australian State of Victoria in a given year. Victoria has developed a relatively comprehensive injury surveillance system. Data is currently collected by various agencies on injury deaths, hospitalisations and emergency department attendances. The method used to establish the incidence of both unintentional and intentional injury is described. Incidence figures were directly derived, or estimated from, the available Victorian health sector and Coronial data bases for three level of severity (deaths, hospitalisations and medical treatment only) and for causes of injury, age and gender groups, location of the injury event and activity at the time of injury. In 1993/1994, injuries resulted in at least 1487 deaths, 67,402 persons hospitalised and an estimated 397,160 medically-treated, non-hospitalised injured persons in Victoria. In total, over 466,000 people were injured or 10.5 persons per year for every 100 residents. Males sustain 62% of all injuries yet represent 49.5% of the population. Almost three-quarters of injury fatalities and over 60% of non-fatal injuries occur among males. Young people aged 15-24 years account for 22% of all injuries yet represent only about 16% of the Victorian population. Children (0-14 years) also suffer relatively high injury rates, although mainly less severe, while the elderly are at risk of more severe injuries. The leading cause of injury death in Victoria is suicide, followed by motor vehicle accidents, whereas falls are the leading cause of all non-fatal injury. Most injuries occur in the home (36%), areas of sport and recreation (12.5%) and transport (11.7%). They are mainly associated with leisure activities (33.1%), work (11%) and transportation (10.8%). This study demonstrates a method for the development of comprehensive injury incidence estimates. The results indicate that injuries have a significant impact on the Victorian community, health care system and economy in general. Reliable incidence data are necessary for descriptive epidemiology and provide the basis for quality of life and economic cost studies. Together this information has potential application for evidence-based strategic planning and evaluation in injury research and prevention.

Background Australia9s workforce is ageing due to demographic and economic factors. Aims (1) To describe the dimensions, nature, and external causes of fatalities in workers aged 55 years and older, Australia, 2000–2009. (2) To provide baseline data for future studies. (3) To investigate the preparedness of high risk industries and workers for the safety of the ageing workforce. Methods Retrospective descriptive cohort data for workers aged 55 years and older (2000–2009) were extracted from population-based mortality data and analysed by age, gender, industry, occupation, and external cause. Subsequent studies investigated the preparedness of industry (stakeholder interviews) and workers (focus groups) for ageing workforce safety in the agriculture, transport and construction industries. Results Of 2283 unintentional work-related fatalities: 336 were aged 55 years or older; 218 were 55–64; 83 were 65–74; 35 were 75 years or older; and 96.3% male. Industries with the most deaths among older workers were agriculture (37.8%), transport (19.3%) and construction (16.6%). Common themes among industry stakeholders included: awareness of the ageing workforce, the impact of ongoing heavy physical labour, and related management issues; an assumption that general safety initiatives will adequately cover older worker safety; and concerns about older worker compensation liabilities. The focus group study is in progress and results will be reported. Significance Older worker deaths are a significant problem which will likely grow with workforce ageing. Employers and work authorities will need to consider the specific characteristics and vulnerabilities of older workers to enable implementation of appropriate injury prevention strategies for this population.

Aim: To describe the prevalence, circumstances and consequences of falls among community-dwelling older people in NSW using data from the 2009 NSW Falls Prevention Baseline Survey. Methods: Telephone interviews with a random sample of 5681 NSW residents aged 65 years and over were conducted in 2009. Results: Of those surveyed, 25.6% reported falling in the last year. Of those who fell, 61.2% fell once, 21.4% fell twice, 7.8% fell three times, and 9.5% fell four or more times in the last year. Sixty-six percent of those who fell in the last year were injured and 20.0% visited a hospital as a result of a fall. The most common injuries were cuts, grazes or bruises (71.0%) and sprains or strains (9.9%). Conclusion: The findings of this survey are consistent with previous findings in the published fall injury prevention literature. The results from the survey will assist in the design of community oriented fall injury prevention strategies and will form the baseline measure for the evaluation of the impact of these strategies in NSW.

This study aimed to establish comprehensive estimates of the cost of fall-related injury among older people in NSW. A health service utilisation approach was used to estimate the cost of hospital treatment, residential care and ambulance transport. Other costs were estimated by deriving ratios of inpatient costs to other services from the literature. In the 2006–07 financial year, 251 000 (27%) of older people fell at least once and suffered, in total, an estimated 507 000 falls. An estimated 143 000 medically treated fall-related injuries among older people resulted in lifetime treatment costs of $558.5 million. Although only 18% of these injuries resulted in hospital admission, the cost of care associated with these cases accounted for 84.5% of the total cost. The cost of fall-related injury among older people in NSW in 2006–07 is a significant increase over earlier estimates and underscores the urgent need for effective preventive efforts across the state.

In Australia, nursery furniture is associated with just over 6% of all injuries to children between birth and 3 years of age and 19% (or almost one in five) of all injuries in the first year of life. In the case of injury associated with prams or strollers and high chairs, the vast majority of injuries occur as the result of falls (75 and 83% respectively). Interviews with parents whose children suffered an injury as a result of a fall from a pram or stroller or from a high chair indicate that only a small proportion of the children (28 and 25% respectively) were wearing any form of safety restraint prior to their injury despite the fact that, in both samples, the percentage of safety restraints fitted was about 80%. The potential for serious injury from such falls is great as most injuries in both groups (96 and 75% respectively) were to the head. One death associated with a stroller and one death as a result of a fall from a high chair have been recorded for Victoria between 1985 and 1988. In the absence of mandatory requirements for the design and manufacture of nursery furniture, there is a need to provide information about nursery furniture safety to parents and care-givers through nursery furniture retailers and through maternity hospitals and child health centres. In particular, the promotion of the correct use of an appropriate and effective child restraint is a relatively simple and inexpensive measure that could prevent up to 80% of all injuries associated with the three items of nursery furniture most often related to injury: strollers or prams, high chairs and change tables.

Background Despite considerable advances in falls prevention research and practice, the rate of falls-related hospitalisations continues to increase. Yet, there is some evidence that hip fracture rates, a major cause of fall-related morbidity, are declining. An examination of trends in types of injuries that contribute to the overall fall injury rate is required to understand these conflicting trends. Aim To examine the trends in fall-related hospital admissions by injury type in New South Wales (NSW), Australia. Method A retrospective review of fall-related injury hospitalisations in NSW among individuals aged 65+ years, by injury type, was conducted from 1 July 1998 to 30 June 2009. Incident cases were identified using the referral source field and direct age standardised admission rates were calculated. Negative binomial regression was used to examine the statistical significance of changes in the trend over time of hospitalised fall-related injuries by injury type. Results The overall fall-related hospitalisation rate increased by 1.7% each year (p Conclusion It appears that, while falls prevention efforts in NSW are not yet affecting hospitalised falls injury rates, efforts in relation to bone health may be having an effect in preventing fractures. It is likely that the increase in severe head injuries is due to improvements in diagnosis.

Introduction Burden of disease estimates have been used to inform prioritisation of research needs. In Australia, National Health Priority Areas (NHPAs), of which injury prevention is one, have been identified as priorities for prevention and research. The National Health and Medical Research Council (NHMRC) is the principal source of medical research funding in Australia. This research aims to examine NHMRC funding for each NHPA to quantify the relationship between grants awarded and burden of disease measures. Method A retrospective analysis of NHMRC funding from 2000 to 2008 to assess the strength of correlation between level of funding and the contribution of each NHPA to burden of disease measures (YLD, YLL, DALY) and health system expenditure was conducted. Also examined were observed versus expected research grants by grant type relative to the proportional contribution of each NHPA to DALYs. Results There were 6099 new and continuing grants awarded, ranging from a total of $A94.6 to $A423.3 million during 2000–2008. Both YLL and DALYs were strongly correlated with NHMRC funding. Injury received a lesser number of scholarships, overseas training fellowships, career awards, research project and programme grants than what would be expected based on its proportional contribution to total NHPA DALYs. Conclusion Injury research and investigator training appears to be underfunded by the NHMRC in Australia based on burden of disease measures. Investigator training dollars should be allocated to ensure an optimum workforce distribution that is capable of undertaking research in areas deemed to be of national importance.

On July 1, 1990, the legislation requiring wearing of an approved bicycle (safety) helmet by all pedal cyclists, unless exempted, came into effect in Victoria, Australia. The paper describes the more important activities which paved the way for this initiative and presents some preliminary information about the effect of the legislation on wearing rates and head injuries. Since 1980 there has been promotion of helmet use through bicycle education in schools, mass media publicity, support by professional organizations and community groups, bulk purchase schemes, and government rebates for helmet purchases. The Australian Standard for bicycle safety helmets has also been changed to meet community demands for lighter helmets with more provision for ventilation. There has been a steady increase in voluntary helmet use in Melbourne from 1983 to March 1990, as follows: 5% to 70% in primary school children; 2% to 20% in secondary students; and 27% to 40% in adults. In the period after the legislation, with relatively little enforcement, these three groups have shown substantial increases in helmet use rates, rising to 70-90% in most cases. Preliminary data show that the numbers of bicyclists with a head injury have dropped in the period since the legislation came into effect. The possible contributions to this reduction, of less bicycle use and lower risk of head injury in an accident, are discussed.

The paper presents a family systems nursing approach to premenstrual syndrome. The interaction between premenstrual syndrome and family dynamics becomes the focus for the clinical nurse specialist and her team. A case example illustrates the use of the interview guidelines of hypothesizing, circularity and neutrality and various systemic-strategic interventions. through this process the couple's maladaptive patterns of interaction are interrupted. Symptom prescription, symptom sharing, symptom escalation, and positive connotation are among the creative interventions used to release premenstrual syndrome from its triangulated position in the marriage.

Two experiments showed that apparent displacement from exact vertical bisection, a variant of the Poggendorff effect reported by Tolansky (1964), occurs not only with three vertical lines or three dots on oblique parallels but with three vertical lines or three dots alone. The size of the effect without parallels was no different from that with parallels. The second of the two experiments, with separate groups of subjects, was a control for the possible influence of one condition on another in the first. The occurrence of the bisection form of the Poggendorff displacement effect is interpreted in terms of a perceptual compromise between exact bisection relative to the vertical and that relative to the main direction of the figure. This direction can be delineated by either parallel lines or obliquely positioned elements.

With a focus on providing concrete teaching strategies for scholars, the Handbook on Teaching and Learning in Political Science and International Relations blends both theory and practice in an accessible and clear manner. In an effort to help faculty excel as classroom teachers, the expert contributors offer representation from various types of institutions located throughout the world. Split into three distinct parts, this book discusses curriculum and course design, teaching subject areas and in class teaching techniques.