Parents' concerns about Leavers celebrations: A cross-sectional study.

ISSUE ADDRESSED: "Schoolies' or "Leavers' is a mass celebration of the end of compulsory schooling where excessive drinking is considered integral to the experience. Leavers are at risk of alcohol-related harms. This paper reports the concerns of parents for their Year 12 students (age 17 years) when attending Leavers celebrations. METHODS: Parents of Year 12 students (n = 87) were asked to complete a survey in relation to their eldest school-aged child. Six items relating to parents' level of "concern' about Leavers celebrations were measured on a 5-point scale. RESULTS: Parents were concerned about their child experiencing peer pressure to consume alcohol (60%), 30% were neutral or unconcerned about peer pressure. Almost two thirds of parents were concerned about their child being injured as a result of their own alcohol use (66.7%). Parental concern relating to their child being injured because of others' alcohol use rated most highly (88.5%). CONCLUSIONS: Findings suggested that parents were more concerned with harm caused to their child by others than the use of alcohol by their own child. Parents were somewhat less concerned with peer pressure to drink, though given peer influence is a major factor in young people's decisions regarding alcohol, parents' apparent confidence in their children's capacity to resist peer pressure may be inflated. SO WHAT?: Future interventions reinforcing the important role that parents play in the decisions that young people make while at Leavers have the potential to reduce their alcohol intake and subsequent alcohol-related harm.

Does Direct Helicopter Retrieval Improve Survival of Severely Injured Trauma Patients From Rural Western Australia?

OBJECTIVE: In remote Western Australia, mortality from major trauma is more than 4 times higher than mortality rates from major trauma in the capital city of Perth. The objective of this study was to determine whether direct helicopter emergency medical service (HEMS) retrieval from an incident scene within the zone 50 to 250 km of Perth to a tertiary hospital improves survival in severely injured trauma patients. Direct HEMS retrieval was compared with indirect retrieval whereby patients were transferred by ambulance to a nearby rural hospital before retrieval to a tertiary hospital in Perth. METHODS: A retrospective analysis (2006-2015) was undertaken of all Western Australia trauma registries, and coronial data were collected for all major trauma patients who died before retrieval to a tertiary hospital in Perth. RESULTS: A total of 1,374 major trauma patients (indirect retrieval = 1,031 and direct HEMS = 343) met the study inclusion criteria. There was a 51% increased risk of death in the indirect patients compared with the direct HEMS patients (15.3% vs. 10.2%, P ≤ .001). CONCLUSION: Direct HEMS retrieval from the incident scene to a tertiary hospital substantially improves the chances of survival for severely injured trauma patients in rural locations in the zone 50 to 250 km of Perth.

Fat talk: Influences on body image in childcare.

ISSUE ADDRESSED: This research explored the use of "fat talk" by early childhood educators and their awareness of their potential influence on the developing body image of young children. METHODS: Mixed methods comprising focus groups, telephone interviews and demographic surveys with 44 early childhood educators Australia-wide. RESULTS: Findings showed many educators in this research recognised that they had a role to play in the development of children's body image, though some were unsure when body image began to develop. Educators engaged widely in "fat talk," in the vicinity of children or other educators, and accepted such talk as normal. DISCUSSION: "Fat talk" features in the workplace and is commonly used by early childhood educators. Its influence on the development of body image on young children did not appear to be well understood by early years' educators or of a concern to them. CONCLUSIONS: Since body image develops in children from around three years of age, the role of early childhood educators in its development should not be overlooked. SO WHAT? RELEVANCE TO HEALTH PROMOTION: Body image is a misunderstood public health concern, with long-term impacts on weight, mental health and physical health. Promotion of positive body image and the early recognition of body image disturbance are crucial, as children who exhibit body dissatisfaction in their formative years have a greater risk of severe body image disturbance as they progress through childhood and adolescence. Since early childhood educators spend significant time with children, encouraging them to avoid engaging in "fat talk" and instead to promote positive body image is warranted.

The Highs and Lows of Making a Bucket List-Quantifying Potential Mosquito Breeding Habitats in Metropolitan Backyards.

While the development of land for residential housing along the Swan and Canning Rivers in Perth, WA, Australia has reduced natural mosquito breeding sites, the role of backyard container breeding remains a relatively unknown factor. Local Governments responsible for these areas focus management and control efforts on low lying, tidally driven mosquito habitats to control Aedes vigilax (Skuse) and Aedes camptorhynchus (Thomson) mosquitoes in an effort to reduce both the nuisance and disease risk to residents. In spite of their efforts, Local Governments continue to receive complaints regarding mosquito nuisance, even when environmental conditions do not favor hatching and development of the two species in the Swan River tidal flats. In this study, 150 backyard inspections were conducted in the residential suburb of Bassendean, Perth, WA, Australia, situated in close proximity to the Swan River tidal plain. The occurrence and species composition of the mosquito fauna found in residential backyards was documented. Of the backyards inspected, 94% were found to possess containers capable of breeding mosquitoes, although only 3% contained mosquito larvae. Nine species of mosquito were collected from containers ranging in capacity from 0.05 to 50 L across the study area. Additionally, encephalitis virus surveillance trapping was conducted within residential properties and compared to the tidally driven natural habitat at Ashfield Flats and a tidally influenced brackish creekline at Bindaring Park. The species composition of the fauna at the three habitat types differed significantly, with Aedes notoscriptus (Skuse) dominating residential lots and A. vigilax more prevalent at the saltmarsh site. Bindaring Park had an adult composition at the mid-point of these two habitats, reflecting its proximity to both the Swan River and residential lots.

Designing programmes of assessment: A participatory approach.

Programmatic approaches to assessment provide purposeful and meaningful assessment yet few examples of their development exist. The aim of this study was to describe the development of a programme of assessment using a participatory action research (PAR) approach. Nine work-based assessors together with three academics met on six occasions to explore the current approach to competency-based assessment in the placement component of a dietetics university course, the findings of which were used to design a programme of assessment. Findings revealed disconnect between current assessment approaches and best practice. The PAR methodology fostered a shared vision for the design of a programmatic approach to assessment and strong leadership was essential. Participants experienced a philosophical shift in their views towards assessment, supporting the implementation of a new assessment programme. This paper is the first to describe a PAR approach as a feasible and effective way forward in the design of programmatic assessment. The approach engaged stakeholders to strengthen their abilities as work-based assessors and produced champions for best practice assessment.

"Looking over the Backyard Fence": Householders and Mosquito Control.

(1) Background: Vector-borne diseases are a significant public health problem in Western Australia. Mosquitoes are responsible for the transmission of a number of pathogens and may pose a serious nuisance problem. Prevention efforts in the State are multi-faceted and include physical, chemical, and cultural control methods for restricting mosquito breeding. This is less complex where breeding areas are located within public open spaces. In Australia's developed urban areas, breeding sites are, however, frequently located within private residential landholdings, where the scope of public health officials to act is constrained by law and practicality. Consequently, mosquito prevention in these locations is predominantly the responsibility of the residents. This research addressed a gap, both in understanding the degree to which "backyard" mosquito breeding has the potential to contribute to local mosquito problems, and in assessing what residents "think and do" about mosquito control within their home environment. (2) Methods: The study was conducted in the Town of Bassendean, a metropolitan Local Government Area of Perth, Western Australia, in close proximity to two natural, productive mosquito breeding sites, namely Ashfield Flats and Bindaring Park. A total of 150 householders were randomly surveyed during the summer of 2015-2016, to gauge residents' knowledge, attitudes, and practices (KAP (knowledge, attitudes, and practices) Survey) in regards to mosquitoes, their breeding and ecology, and avoidance or minimization strategies. The survey comprised nine questions covering residents' knowledge (3 questions), attitudes (3 questions), and practices (3 questions), as well as additional questions regarding the basic demographics of the resident. Larvae were collected from backyard containers and reared to adults for species identification. A series of Encephalitis Vector Surveillance carbon dioxide (EVS CO2) traps were also deployed, to assess adult mosquito density and species composition. (3) Results: Aedes notoscriptus (Skuse), a known container-inhabiting species, accounted for just over 50% of all mosquitoes identified. Most residents were aware of mosquito-borne disease and its risk in their local area. While the majority (79%) of the sample correctly identified Ross River virus as the most common infection in WA, a significant gap in the general knowledge of residents in regards to mosquito biology and breeding habits, was noted. Furthermore, only 50% of residents reported using personal protective measures to reduce mosquito bites and only one in six residents undertook physical or chemical mosquito control around their home. Additionally, 60% of respondents believed that mosquito control was "a job for the council and the state government", rather than for individual householders. (4) Conclusions: A significant gap in the knowledge of residents in the study area existed in regards to the general knowledge of mosquitoes and their breeding habits; types of treatments that could be employed within the home; and the residents' responsibility for the management of mosquito breeding on their private property. A public education campaign has been deployed to educate the residents.

Maternity-care: measuring women's perceptions.

PURPOSE: Achieving maternity-care outcomes that align with women's needs, preferences and expectations is important but theoretically driven measures of women's satisfaction with their entire maternity-care experience do not appear to exist. The purpose of this paper is to outline the development of an instrument to assess women's perception of their entire maternity-care experience. DESIGN/METHODOLOGY/APPROACH: A questionnaire was developed on the basis of previous research and informed by a framework of standard service quality categories covering the spectrum of typical consumer concerns. A pilot survey with a sample of 195 women who had recent experience of birth was undertaken to establish valid and reliable scales pertaining to different stages of maternity care. Exploratory factor analysis was used to interpret scales and convergent validity was assessed using a modified version of the Client Satisfaction Questionnaire. FINDINGS: Nine theoretically informed, reliable and valid stand-alone scales measuring the achievement of different dimensions of women's expectancies of public maternity care were developed. The study scales are intended for use in identifying some potential areas of focus for quality improvement in the delivery of maternity care. RESEARCH LIMITATIONS/IMPLICATIONS: Reliable and valid tools for monitoring the extent to which services respond to women's expectations of their entire maternity care form part of the broader toolkit required to adequately manage health-care quality. This study offers guidance on the make-up of such tools. ORIGINALITY/VALUE: The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.

Maternity care: a narrative overview of what women expect across their care continuum.

OBJECTIVES: to provide a narrative overview of the values schema underpinning women׳s expectations of public maternity-care services using an episodes-of-care framework. DESIGN: focus-group discussions and in-depth interviews were undertaken with Western Australian women who had opted for public maternity care to determine the values schema apparent in their expectations of their care. SETTING: public maternity-care services in metropolitan (i.e. Armadale, Osborne Park and Rockingham) and regional (i.e. Broome, Geraldton, Bunbury) Western Australia. FINDINGS: women interviewed were found to have consistent values schema underpinning their maternity-care expectations and evaluations. CONCLUSIONS: the current study suggests that while women׳s choices and experiences of maternity care may differ on a range of dimensions, the values schema underlying their care expectations and subsequent evaluations are similar. The study findings resonate with past Australian research regarding women׳s expectations of public maternity care, but complement it by providing a coherent narrative of core underpinning stage-specific values schema. These may assist maternity-care policy makers, practitioners and researchers seeking to better understand and comprehensively respond to women׳s maternity-care expectations.

'What women want': Using image theory to develop expectations of maternity care framework.

OBJECTIVES: to develop, in consultation with women, a theoretically-grounded framework to guide the assessment of women's maternity-care experiences. DESIGN: qualitative research was undertaken with women to examine the appropriateness of Image Theory as a heuristic for understanding how women plan and evaluate their maternity-care experiences. SETTING: maternity-care services in metropolitan and regional communities in Western Australia. OUTCOMES: an Episodes of Maternity Care Framework grounded in Image Theory was established that addressed various domains of women's perceptions and expectations of their maternity-care experience. CONCLUSIONS: previously-identified weaknesses of methods used to measure patient satisfaction were addressed and a valid framework for investigating women's perception of their maternity-services experiences was developed. This framework has the potential to contribute to the ongoing development and improvement of maternity-care service.

Effect of joint iron and zinc supplementation on malarial infection and anaemia.

OBJECTIVE: In spite of interventions being put in place to reduce the burden of maternal anaemia and malaria in Ghana, they continue to impact negatively on pregnancy outcomes. It is unclear whether there are some other factors that limit the effectiveness of these interventions. The aim of this study was to explore whether there are benefits associated with the addition of zinc to the routine malaria chemoprophylaxis, iron and folic acid intervention package for pregnant women in Ghana. DESIGN: A double-blind, randomised controlled trial (RCT) conducted in the Upper West Region of Ghana. RESULTS: Iron-zinc supplementation reduced the risk of increased malaria parasitaemia associated with high maternal serum ferritin and Hb concentrations. Iron-zinc supplementation was associated with reduced malaria parasite densities, F (1, 20) = 4.744, p = 0.042. Iron and zinc provided in the ratio of 1:1 prevented a significant decline in maternal iron stores of pregnant women. Adjusted geometric mean serum ferritin concentration in the Iron-zinc Group was significantly higher than in the Control Group (22.9 microg/L versus 16.9 microg/L), F (1, 156)= 6.336, p = 0.013 CONCLUSIONS: Joint iron and zinc supplementation appears to be a better option than iron-only supplementation in malaria-endemic areas.

Effect of prenatal zinc supplementation on birthweight.

Although iron and zinc deficiencies are known to occur together and also appear to be high in Ghana, a few supplementation studies addressed this concurrently in pregnancy. In a double-blind, randomized controlled trial, 600 pregnant women in Ghana were randomly assigned to receive either a combined supplement of 40 mg of zinc as zinc gluconate and 40 mg of iron as ferrous sulphate or 40 mg of elemental iron as ferrous sulphate. Overall, there was no detectable difference in the mean birthweight between the study groups, although the effect of iron-zinc supplementation on the mean birthweight was masked by a strong interaction between the type of supplement and the iron status of participants [F (1,179) = 5.614, p = 0.019]. Prenatal iron-zinc supplementation was effective in increasing the mean birthweight among anaemic and iron-deficient women but not among women with elevated iron stores in early pregnancy.

The impact of a parent-directed intervention on parent-child communication about tobacco and alcohol.

INTRODUCTION AND AIM: Given the likelihood of engaging in the hazardous use of tobacco and alcohol increases during teenage years, pre-adolescence is a critical time to implement prevention programmes. While social factors other than those associated with parenting play a role in determining a child's risk for initiation of tobacco and alcohol use, parents can have a significant influence on their children's decisions about these issues. The aim of this study was to assess the impact of an in-home parent-directed drug education intervention on parent-child communication about tobacco and alcohol. DESIGN AND METHODS: A group randomised intervention trial was conducted in Perth, Western Australia. Schools were selected using stratified random sampling and randomised to three study conditions. A total of 1201 parents of 10- 11-year-old children were recruited from 20 schools. The impact of a self-help intervention, comprised of five communication sheets containing information and activities designed to encourage parents to talk with their 10- 11-year-old child about issues related to smoking cigarettes and drinking alcohol, was assessed. RESULTS: Intervention-group parents were more likely to have spoken with their children, to have spoken more recently, to have engaged the child during the discussion and to have addressed the topics identified as being protective of children's involvement in tobacco and alcohol. In addition, the duration of talks about alcohol was longer than for parents in the comparison group. DISCUSSION AND CONCLUSIONS: Parents of 10- 11-year-old children appear to be receptive to participating in a home-based drug-related educational intervention and the parent-directed intervention seems to have enhanced parent-child tobacco- and alcohol-related communication.

Investigating parental preferences regarding the development and implementation of a parent-directed drug-related educational intervention: an exploratory study.

Strengthening parents' capacity to reduce children's risk of alcohol, tobacco and other drug-related harm is recognised as an important public health strategy in Australia, but engaging parents' involvement in these training programs is known to be challenging. This study utilised a self-complete questionnaire and structured small group discussions with parents in order to identify their needs in terms of communicating with their children about drinking alcohol and smoking cigarettes. It also investigated their preferences regarding the nature of a parent drug education intervention as well as strategies to recruit and actively engage them in parent-directed interventions. Parents identified numerous barriers to their participation in such programs and reported any intervention targeting them should be able to be completed in their home, be non-judgemental, easy to read, time-efficient, easy to use, fun, colourful and interactive. Parents recommended practical communication skills (such as how to talk with children, how to raise the topic and what topics to talk about) be addressed in the intervention. They also recommended a range and combination of strategies to promote and maintain parent involvement, such as providing small rewards for the children of parents who participate. Despite some limitations, the findings of this study contribute important practical knowledge regarding how to recruit, engage and retain higher percentages of parents in parent training programs.