[show abstract][hide abstract] ABSTRACT: Sick leave due to neck pain (NP-SL) is costly and negatively impacts the productivity of the nursing and midwifery workforce. Identification of modifiable risk indicators is necessary to inform preventive efforts. This study aimed to investigate the role of pain-related psychological features (pain catastrophizing, fear of movement, and pain coping) in NP-SL alongside other potential risk indicators.
A cross-sectional analysis of a large cohort study of Australian and New Zealand nurses and midwives, established between 1st April 2006 to 30th March 2008, was undertaken. Recruitment procedures adopted within each Nursing Council jurisdiction were governed by the individual regulatory authorities and their willingness to engage with the study. Invitations directed potential participants to a purpose-built internet-based survey, where study information was provided and consent requested. Once consent was obtained, a range of standardized tools combined into one comprehensive electronic questionnaire was elicited. Exposure variables assessed included pain characteristics and a broad range of psychological, psychosocial, occupational, general health and demographic factors. Two-way interactions between age and gender and candidate exposures were also assessed. Binary logistic regression was performed using manual backward stepwise elimination of non-significant terms.
The cohort included 4,903 currently working nurses or midwives aged 18-65 years. Of these, 2,481 (50.6%) reported neck pain in the preceding 12 months. Our sample comprised of 1,854 working nurses and midwives with neck pain in the preceding year who supplied sick leave data. Of these, 343 (18.5%) reported taking sick leave in the preceding year due to their neck pain. The final most parsimonious multivariable model demonstrated neck pain severity (adjusted odds ratio, [aOR] = 1.59), passive pain coping (aOR = 1.08) and fear of movement (aOR = 1.06) increased the likelihood of NP-SL in the previous year. Interactions between demographic and general health factors exhibited both protective and risk relationships with NP-SL, and there was no association between pain catastrophizing and NP-SL.
Findings demonstrate that sick leave due to neck pain was associated with pain severity, fear of movement and passive pain coping. In addition, there were complex interactions found between demographic and general health factors. These features represent potentially modifiable targets for preventive programs.
[show abstract][hide abstract] ABSTRACT: In 2006 there were 432,700 people in Australia who had acquired brain injury (ABI) with some limitation of activities; 90% of these were traumatic brain injuries (TBIs) and nearly a third sustained injury below age 15 years. One to four years post injury, 20% to 46% of children with traumatic brain injury (TBI) have clinically significant disorders of attention. There is controversy as to whether central nervous system (CNS) stimulants can be an effective method of treating these.Objectives were to determine the efficacy of CNS stimulants for children with TBI, and to calculate the sample size for a larger trial using the Conners' Long Forms Parent Rating Scales Score as the primary endpoint.
Pilot series of aggregated prospective randomised, double-blind, n-of-1 trials of stimulant versus placebo within individual patients. Setting: tertiary children's public hospital. Participants: ten children aged 6 to 16 years more than 12 months post TBIwith attention, concentration and behavioral difficulties on stimulants. Interventions: Three cycles of methylphenidate or dexamphetamine orally at doses titrated by physician compared to placebo. Main Outcome Measures: Conners 3 Parent (Conners 3-P) and Teacher (Conners 3-T) Rating Scales (Global Index), Behaviour Rating Inventory of Executive Function (BRIEF) and Eyberg Child Behaviour Inventory (ECBI).
Five of ten patients completed the study. Data from 18 completed cycles from seven patients were analysed. The posterior mean difference between stimulant and placebo scores for the Conners 3-PS (Global Index) was 2.3 (SD 6.2; 95% credible region -1.0 to 6.1; posterior probability that this mean difference was greater than zero was 0.92), and for the Conners 3-T (Global Index) the posterior mean difference was 5.9 (SD 4.5; 95% credible region -3.1 to 14.9; posterior probability 0.93). Posterior mean differences suggest improvement in behaviour and executive function and a decrease in number and intensity of child behaviour problems when taking stimulants compared to placebo. Taken together these data are suggestive of a small benefit at group level.
In this pilot study, there was sufficient evidence that stimulants may be useful in management of behavioral and cognitive sequelae following TBI, to warrant a larger trial.Trial registration: The trial was registered with the Australian and New Zealand Clinical Trials Registry: registration number ACTRN12609000873224.
[show abstract][hide abstract] ABSTRACT: Background: Breaks in sedentary behavior are associated with reduced body size in general populations. This study is the first to consider the relationship between objectively assessed sedentary breaks and body size in Pacific children and their mothers. Methods: Pacific children aged 6 years (n = 393) and their mothers (n = 386) residing in New Zealand were invited to participate in 2006. Sedentary time was assessed via accelerometry. Average frequency, duration, and intensity of breaks in sedentary time per hour were calculated. Waist circumference was assessed and demographic factors collected via questionnaire. Relationships between waist circumference and potential associated factors for participants were assessed using linear regression analyses. Results: Accelerometer data were obtained from 126 children (52 boys) and 108 mothers. Mean (standard deviation) waist circumference values for mothers and children were 114 cm (20.1 cm) and 59.4 cm (7.8 cm), respectively. For mothers, time spent sedentary and being an ex/nonsmoker were positively related to waist circumference. For children, watching television every day and having a mother with a high waist circumference was associated with a greater waist circumference. Conclusion: Strategies that focus on reducing sedentary time in Pacific mothers and on encouraging television free days in young Pacific children are recommended.
Journal of Physical Activity and Health 11/2013; 10(8):1166-74. · 1.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: It is estimated that 39,000 Australians die from malignant disease yearly. Of these, 60% to 88% of advanced cancer patients suffer xerostomia, the subjective feeling of mouth dryness. Xerostomia has significant physical, social and psychological consequences which compromise function and quality of life. Pilocarpine is one treatment for xerostomia. Most studies have shown some variation in individual response to pilocarpine, in terms of dose used, and timing and extent of response.We will determine a population estimate of the efficacy of pilocarpine drops (6 mg) three times daily compared to placebo in relieving dry mouth in palliative care (PC) patients. A secondary aim is to assess individual patients' response to pilocarpine and provide reports detailing individual response to patients and their treating clinician.
Aggregated n-of-1 trials (3 cycle, double blind, placebo-controlled crossover trials using standardized measures of effect). Individual trials will identify which patients respond to the medication. To produce a population estimate of a treatment effect, the results of all cycles will be aggregated.
Managing dry mouth with treatment supported by the best possible evidence will improve functional status of patients, and improve quality of life for patients and carers. Using n-of-1 trials will accelerate the rate of accumulation of high-grade evidence to support clinical therapies used in PC.Trial registration: Australia and New Zealand Clinical Trial Registry Number: 12610000840088.
BMC Palliative Care 10/2013; 12(1):39. · 1.12 Impact Factor
[show abstract][hide abstract] ABSTRACT: Paper-based Aboriginal and Torres Strait Islander health checks have promoted a preventive approach to primary care and provided data to support research at the Inala Indigenous Health Service, south-west Brisbane, Australia. Concerns about the limitations of paper-based health checks prompted us to change to a computerised system to realise potential benefits for clinical services and research capability. We describe the rationale, implementation and anticipated benefits of computerised Aboriginal and Torres Strait Islander health checks in one primary health care setting.
In May 2010, the Inala Indigenous Health Service commenced a project to computerise Aboriginal and Torres Strait Islander child, adult, diabetic, and antenatal health checks. The computerised health checks were launched in September 2010 and then evaluated for staff satisfaction, research consent rate and uptake. Ethical approval for health check data to be used for research purposes was granted in December 2010.
Three months after the September 2010 launch date, all but two health checks (378 out of 380, 99.5%) had been completed using the computerised system. Staff gave the system a median mark of 8 out of 10 (range 5-9), where 10 represented the highest level of overall satisfaction. By September 2011, 1099 child and adult health checks, 138 annual diabetic checks and 52 of the newly introduced antenatal checks had been completed. These numbers of computerised health checks are greater than for the previous year (2010) of paper-based health checks with a risk difference of 0.07 (95% confidence interval 0.05, 0.10). Additionally, two research projects based on computerised health check data were underway.
The Inala Indigenous Health Service has demonstrated that moving from paper-based Aboriginal and Torres Strait Islander health checks to a system using computerised health checks is feasible and can facilitate research. We expect computerised health checks will improve clinical care and continue to enable research projects using validated data, reflecting the local Aboriginal and Torres Strait Islander community's priorities.
BMC Medical Informatics and Decision Making 09/2013; 13(1):108. · 1.60 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: It is estimated that 22,800 children were living with an Acquired Brain Injury (ABI) (0.6% of children aged under 15 years) in Australia during 2003. Many children after a traumatic brain injury will experience difficulties with attention and concentration; a condition termed secondary Attention Deficit-Hyperactivity Disorder. There is conflicting evidence on whether treatment with stimulant therapy with medications such as methylphenidate or dexamphetamine will improve the attention and behavior of children with this condition.Methods/design: Single patient trials (n-of-1s or SPTs) evaluate the effect of titrated doses of psychostimulants methylphenidate or dexamphetamine compared to placebo on attention and behavior, in children with TBI and secondary ADHD. The aggregation of multiple SPTs will produce a population estimate of the benefit. Forty-two children will be registered into the trial through rehabilitation services at three large children's hospitals in Australia. Patients will complete up to 3 cycles of treatment. Each cycle is 2 weeks long comprising seven days each of treatment and placebo, with the first two days of each cycle considered a washout period and the data not analysed. The order of treatment and placebo is randomly allocated for each cycle. The Conners' Parent Rating Scales long forms will be employed to measure change in attention-deficit/hyperactivity and related problems of the child, and the primary outcome measure is the Conners' Global Index Parent Version. Secondary outcomes include the teacher and child (if aged > 12 years) Conners' Rating Scales, the Behaviour Rating Inventory of Executive Function among other measures. This study will provide high-level evidence using a novel methodological approach to inform clinicians about the most appropriate treatment for individual children. Through aggregation of individual trials, a population estimate of treatment effect will be provided to guide clinical practice in the treatment of children with secondary ADHD after a traumatic brain injury. DISCUSSION: This study employs an innovative methodological approach on the effectiveness of CNS stimulants for secondary ADHD from a brain injury. The findings will both guide clinicians on treatment recommendations, and inform the concept and acceptance of SPTs in paediatric research.Trial registration: Australian New Zealand Clinical Trials Registry. ACTRN12609000873224(https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12609000873224).
[show abstract][hide abstract] ABSTRACT: BACKGROUND: It is estimated that 29% of deaths in Australia are caused by malignant disease each year and can be expected to increase with population ageing. In advanced cancer, the prevalence of fatigue is high at 70--90%, and can be related to the disease and/or the treatment. The negative impact of fatigue on function (physical, mental, social and spiritual) and quality of life is substantial for many palliative patients as well as their families/carers.Method/design: This paper describes the design of single patient trials (n-of-1 s or SPTs) of a psychostimulant, methylphenidate hydrochloride (MPH) (5 mg bd), compared to placebo as a treatment for fatigue, with a population estimate of the benefit by the aggregation of multiple SPTs. Forty patients who have advanced cancer will be enrolled through specialist palliative care services in Australia. Patients will complete up to 3 cycles of treatment. Each cycle is 6 days long and has 3 days treatment and 3 days placebo. The order of treatment and placebo is randomly allocated for each cycle. The primary outcome is a reduction in fatigue severity as measured by the Functional Assessment of Cancer Therapy-fatigue subscale (FACIT-F). Secondary outcomes include adverse events, quality of life, additional fatigue assessments, depression and Australian Karnovsky Performance Scale. DISCUSSION: This study will provide high-level evidence using a novel methodological approach about the effectiveness of psychostimulants for cancer-related fatigue. If effective, the findings will guide clinical practice in reducing this prevalent condition to improve function and quality of life.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000794202 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12609000794202.
BMC Palliative Care 04/2013; 12(1):17. · 1.12 Impact Factor
[show abstract][hide abstract] ABSTRACT: Workplace bullying is repeated systematic, interpersonal abusive behaviours that negatively affect the targeted individual and the organisation in which they work. It is generally the result of actual or perceived power imbalances between perpetrator and victim, and includes behaviours that intimidate, offend, degrade or humiliate a worker. It is illegal, and bullied employees can take legal action against their employers for a breach of implied duty of trust and confidence. Despite this, workplace bullying occurs in many Australian workplaces, including Australian general practices.
This article explores the issue of workplace bullying with particular reference to bullying within general practice and provides a framework for managing these situations.
All general practices need organisation-wide anti-bullying policies that are endorsed by senior management, clearly define workplace bullying, and provide a safe procedure for reporting bullying behaviours. General practitioners should investigate whether workplace issues are a potential contributor to patients who present with depression and/or anxiety and assess the mental health of patients who do disclose that they are victims of workplace bullying, Importantly, the GP should reassure their patient that bullying is unacceptable and illegal, and that everyone has the right to a safe workplace free from violence, harassment and bullying. The time has come for all workplaces to acknowledge that workplace bullying is unacceptable and intolerable.
Australian family physician 04/2013; 42(4):186-8. · 0.71 Impact Factor
[show abstract][hide abstract] ABSTRACT: Harmful alcohol consumption amongst Pacific people (those of Polynesian descent) is recognized as a public health priority in New Zealand, yet little epidemiological information exists on this pattern of drinking. Using a large birth cohort study, which includes the mother, father and child triad, this study aims to determine the prevalence and change in any harmful drinking levels prenatally, antenatally and in the postpartum period for mothers and fathers, and to measure the concordance of both partners' reports of that drinking in an ethnically representative sample of Pacific families within New Zealand. Participants were selected from births where at least one parent was identified as being of Pacific ethnicity and a New Zealand permanent resident (1376 mothers and 825 fathers at baseline); many of whom are young to middle aged adults. These participants have been prospectively followed-up multiple times since. The Alcohol Use Disorders Identification Test consumption questions (AUDIT-C) were used over successive measurement waves to define any and harmful drinking levels. Recommended screening thresholds were employed. Longitudinal analyses on complete cases and imputed data, accounting for differential attrition, were undertaken and reported. Clear temporal patterns of alcohol consumption emerged for both mothers and fathers, together with significant and important ethnic differences. Moreover, there was considerable movement in alcohol consumption categories between consecutive measurement waves for both mothers and fathers. Among couples, there was significant asymmetry in drinking patterns and poor statistical agreement. However, 9.1% (14.1% in imputed analyses) of Pacific children aged 2 years had both parents indicated for harmful drinking. The significant important heterogeneity and ethnic differences suggest that both ethnic-specific and pan-Pacific interventions and prevention strategies are likely needed for successful interventions. More emphasis should be placed on targeting and addressing parents' alcohol misuse, particularly in the antenatal or postnatal period.
[show abstract][hide abstract] ABSTRACT: To determine the frequency and types of stressful events experienced by urban Aboriginal and Torres Strait Islander children, and to explore the relationship between these experiences and the children's physical health and parental concerns about their behaviour and learning ability.
Cross-sectional study of Aboriginal and Torres Strait Islander children aged ≤ 14 2013s presenting to an urban Indigenous primary health care service in Brisbane for annual child health checks between March 2007 and March 2010.
Parental or carer report of stressful events ever occurring in the family that may have affected the child.
Of 344 participating children, 175 (51%) had experienced at least one stressful event. Reported events included the death of a family member or close friend (40; 23%), parental divorce or separation (28; 16%), witness to violence or abuse (20; 11%), or incarceration of a family member (7; 4%). These children were more likely to have parents or carers concerned about their behaviour (P < 0.001) and to have a history of ear (P < 0.001) or skin (P = 0.003) infections.
Children who had experienced stressful events had poorer physical health and more parental concern about behavioural 1s than those who had not. Parental disclosure in the primary health care setting of stressful events that have affected the child necessitates appropriate medical, psychological or social interventions to ameliorate both the immediate and potential lifelong negative impact. However, treating the impact of stressful events is insufficient without dealing with the broader political and societal 1s that result in a clustering of stressful events in the Aboriginal and Torres Strait Islander population.
The Medical journal of Australia 01/2013; 199(1):42-5. · 2.85 Impact Factor
[show abstract][hide abstract] ABSTRACT: Pacific peoples represent one of the fastest growing population subgroups in New Zealand and suffer disproportionately from diabetes, obesity, and other diseases. There is little research on the predictors of behavioral problems in Pacific children or the role that cultural
variables play in shaping the unique environments in which child development occurs This study aims to examine the: (1) prevalence of behavior problems at 2, 4, and 6 years-of age
among Pacific children, and (2) relationships between maternal, cultural, and socio demographic factors and behavioral problems. Data were gathered from the Pacific Islands Families Study. Maternal reports of child behavior were obtained using the Child Behavior Checklist for over 1000 Pacific children. The prevalence of clinical internalizing
problems at ages 2, 4, and 6 years was 16.8, 22 and 8.5%, and clinical externalizing was 6.7, 10.7, and 14.6% respectively. Significant risk factors associated with clinical
internalizing were maternal depression, maternal smoking, intimate partner violence, and having a single mother. Significant risk factors for clinical externalizing were harsh parenting, maternal depression, having a New Zealand born mother, and low household income. Across dimensions, a protective factor was found for children with mothers who described themselves as strongly aligned with Pacific traditions. These findings contribute to the limited longitudinal data specific to children from different ethnic groups and demonstrate the importance of cultural factors in developmental outcomes.
Journal of Child and Family Studies 01/2013; 22(2):231-243. · 1.12 Impact Factor
[show abstract][hide abstract] ABSTRACT: To report robust and contemporary estimates of permanent teeth emergence ages in children of Māori, Pasifika, Chinese, Indian and European ethnic origin in the Auckland region.
A stratified, two-stage cross-sectional study. Strata were defined by school decile status. Schools defined the first-stage sampling unit, and students the second stage.
Invitations and consent forms were distributed to eligible participants at school for completion at home. Participants were examined at school-based clinics or in a mobile clinic. PARTICIPANTS/MATERIALS, AND METHODS: Children aged between 5 and 13 years enrolled within the Auckland Regional Dental Service. Schools were randomly selected and then all students within selected schools were invited to participate. Eligible participants completing a consent form had an additional tooth assessment that complemented their routine dental examination. A generalised gamma failure-time model was employed to estimate permanent tooth eruption ages.
Visually based assessment of permanent tooth emergence.
Overall, 3,466 children participated. Differences in median permanent tooth emergence ages were seen among ethnic groups and sexes (P < or = 0.01). Pasifika children had earlier median eruption time than sex-matched Māori children, who (in turn) were more advanced than sex-matched European children. Median eruption age occurred earlier in girls than boys for all permanent teeth.
Despite known demographic, geographic and ethnic differences, estimates of permanent teeth emergence timing widely used in New Zealand are based on historical overseas populations. The presented estimates provide new standards and may be more appropriate for dental therapists and dentists when assessing permanent teeth emergence in New Zealand children.
The New Zealand dental journal 06/2012; 108(2):55-61.
[show abstract][hide abstract] ABSTRACT: To compare the effectiveness of tai chi and low-level exercise in reducing falls in older adults; to determine whether mobility, balance, and lower limb strength improved and whether higher doses of tai chi resulted in greater effect.
Randomized controlled trial.
Eleven sites throughout New Zealand.
Six hundred eighty-four community-residing older adults (mean age 74.5; 73% female) with at least one falls risk factor.
Tai chi once a week (TC1) (n = 233); tai chi twice a week (TC2) (n = 220), or a low-level exercise program control group (LLE) (n = 231) for 20 wks.
Number of falls was ascertained according to monthly falls calendars. Mobility (Timed-Up-and-Go Test), balance (step test), and lower limb strength (chair stand test) were assessed.
The adjusted incident rate ratio (IRR) for falls was not significantly different between the TC1 and LLE groups (IRR = 1.05, 95% confidence interval (CI) = 0.83-1.33, P = .70) or between the TC2 and LLE groups (IRR = 0.88, 95% CI = 0.68-1.16, P = .37). Adjusted multilevel mixed-effects Poisson regression showed a significant reduction in logarithmic mean fall rate of -0.050 (95% CI = -0.064 to -0.037, P < .001) per month for all groups. Multilevel fixed-effects analyses indicated improvements in balance (P < .001 right and left leg) and lower limb strength (P < .001) but not mobility (P = .54) in all groups over time, with no differences between the groups (P = .37 (right leg), P = .66 (left leg), P = .21, and P = .44, respectively).
There was no difference in falls rates between the groups, with falls reducing similarly (mean falls rate reduction of 58%) over the 17-month follow-up period. Strength and balance improved similarly in all groups over time.
Journal of the American Geriatrics Society 05/2012; 60(5):841-8. · 3.98 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study aimed to describe the prevalence of perceived workplace bullying in the Australian medical workforce, and investigate the relationship between workplace bullying and job satisfaction, health status, and current and planned medical workforce participation.
An electronic cross-sectional survey of doctors currently in the paid workforce, conducted between April 2008 and October 2009, was nested within a longitudinal cohort study investigating factors affecting the recruitment and retention of the Australian medical workforce. To address the specific aims of this study, a subset of questions in the survey investigated the prevalence of self-reported bullying; physical and mental health; workforce participation patterns; job satisfaction; and job stressors.
Seven hundred and forty-seven participants responded to the bullying question and were included in this analysis. Twenty-five percent of participants reported being bullied in the last 12 months. There were no differences in the reported rates of bullying across age groups, sex and country of medical qualification. Bullied doctors were least satisfied with their jobs (P<0.001), had taken more sick leave in the last 12 months (P<0.001), and were more likely to be planning to decrease the number of hours worked in medicine in the next 12 months (P=0.01) or ceasing direct patient care in the next 5 years (independent of their age or the number of hours currently worked in patient care) (P=0.006).
Our findings suggest that Australian doctors, independent of age or sex, have experienced workplace bullying, and although no conclusions can be made about causal pathways, there were strong associations between this exposure and poorer health and wellbeing, and on remaining in the medical workforce.
Australian health review: a publication of the Australian Hospital Association 05/2012; 36(2):197-204. · 0.70 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objectives
This study aimed to establish the prevalence, pattern and nature of coaches’ verbal behaviour at children’s (ages 6–12 years) team sports events. The study draws upon the motivational model presented by Mageau and Vallerand (2003) to examine the influence of global (gender), contextual (sport related), and social (athlete gender) factors on coach comments.DesignA cross-sectional observational study of coaches stratified across four team sports: Rugby Union, Netball, Association Football and Touch Rugby.Method
The Observation Instrument at Sports Events was used to categorise covertly recorded verbal comments made by coaches at organised team sports games.ResultsOverall, 10,697 comments were recorded at 72 games at a rate of 3.71 comments/minute; 35.4% were categorised as positive, 21.6% as negative, and 43.0% as neutral. Significant differences in negative comments were identified between sport (p < .001) with rugby coaches recording the highest percentage of negative comments and the lowest percentage of positive comments; by coach gender (p < .001), with male coaches recording higher rates of negative comments; and by athlete gender (p < .001), with coaches of male-only teams recording higher rates of negative comments. When simultaneously included in a Poisson regression model the difference in negative comments between sports remained statistically significant (p < .001) whereas coach gender was no longer significant.Conclusions
The ratio of negative coach comments for all sports gives cause for concern. These findings suggest that sports of national and cultural significance are a key driver of coaching behaviours in a competitive environment.
Psychology of Sport and Exercise. 03/2012; 13(2):208–215.
[show abstract][hide abstract] ABSTRACT: A minority of adults in developed countries engage in sufficient physical activity (PA) to achieve health benefits. This study aims to identify modifiable perceived resources and barriers to PA among New Zealand adults.
Secondary analysis of a 2003 nationally representative cross-sectional mail survey, stratified by region, age, and ethnicity, and analyzed utilizing ordinal logistic regression.
Overall, n = 8038 adults responded to the survey, of whom 49% met updated guidelines for sufficient PA. Perceived accessibility of local resources was associated with PA; however, for some resources there was more awareness among individuals whose predominant activity was not commonly associated with that resource (eg, health clubs and walkers). Perceived local environmental barriers demonstrated negative (steep hills, crime, dogs) and positive (unmaintained footpaths) associations. The absence of perceived environmental barriers was strongly associated with increased activity, suggesting the number of barriers may be a critical factor.
Complex relationships between perceptions of local environments and activity patterns among adults were found. Although complex, these results demonstrate positive associations between awareness of resources and perceived lack of barriers with being sufficiently physically active for health. Therefore, investments in provision and/or promotion of local resources have the potential to enable active healthy communities.
Journal of Physical Activity and Health 03/2012; 9(3):367-77. · 1.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: The relationship between long working hours and harmful alcohol consumption reported in the literature is equivocal.
This study aimed to investigate this relationship in a methodologically rigorous fashion.
A cross-sectional analysis of a large cohort study of Australian and New Zealand nurses and midwives was undertaken.
Psychometrically robust standardised assessments of alcohol consumption and problems and other key variables were elicited using an electronic survey. Crude and adjusted logistic regression models using complete case and multistage multiple imputed data were employed.
The study included 4419 participants, 3552 from Australia and 867 from New Zealand. Long working hours were common, with 33.2% working 40-49 h/week and 7.5% working ≥50 h/week. Overall, 13.9% engaged in harmful daily drinking. Significant associations between long working hours and harmful daily alcohol consumption was seen in crude and adjusted complete case and imputed logistic regression models. In the adjusted model with imputed data, the odds of harmful daily drinking increased by 1.17 (95% confidence interval: 1.01, 1.36) between <40 h/week and 40-49 h/week groups, and between 40-49 h/week and ≥50 h/week groups.
Many nurses and midwives engaging in harmful daily drinking and work long hours. Since the late 1970s, the average hours worked by full-time employees in Australia has increased. Unless these long working hours can be curbed, workforce policies and programmes aimed at prevention, supportive and empathetic intervention, and recovery need to be instigated; both to protect patients and the nurses and midwives themselves.
International journal of nursing studies 02/2012; 49(6):701-9. · 1.91 Impact Factor
[show abstract][hide abstract] ABSTRACT: This article explores the relationship between smoking prevalence and acculturation among a cohort of Pacific Island fathers resident in New Zealand.
Overall, 766 Pacific fathers were included in the analysis. Self-reported smoking status was assessed and compared with data from a robust epidemiological measure of acculturation status specifically designed for use amongst the Pacific population. Additional variables describing socio-demographic and other circumstances of the participating fathers were also incorporated in the analysis because of their known association with smoking behaviour.
Overall, 40.3% of Pacific fathers were current smokers. Multivariable logistic regression showed that acculturation status was associated with smoking crude (p<0.001) and multivariable logistic regression models, when adjusting to socio-demographic variables (p=0.008).
Smoking rates for Pacific fathers in New Zealand are high. There appears to be a modest effect of acculturation on smoking prevalence, where those fathers with higher Pacific cultural identity have the lowest smoking rates. It is opined that the strength of identification and a holistic view of health enhances the motivations of Pacific fathers to be smoke-free in New Zealand.
Strategies which maintain, enhance, and incorporate fathers' Pacific cultural identity may be a useful addition to comprehensive tobacco control strategies to reduce the prevalence of smoking in Pacific people living in New Zealand.
Australian and New Zealand Journal of Public Health 12/2011; 35(6):509-16. · 1.64 Impact Factor